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논문 기본 정보

자료유형
학술저널
저자정보
이희종 (울산대학교 의과대학 울산대학교병원) 김성찬 (울산대학교 의과대학 울산대학교병원) 김규남 (서울아산병원 성형외과학교실) 윤치선 (울산대학교 의과대학 울산대학교병원) 홍준표 (서울아산병원 성형외과학교실)
저널정보
대한미세수술학회 대한미세수술학회지 대한미세수술학회지 제22권 제1호
발행연도
2013.1
수록면
33 - 37 (5page)

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Purpose: The concept and development of perforator free flaps have led to significant advances in microsurgery. Ongoing developments in perforator free flap surgery are aimed at reducing complications and improving surgical outcomes. The aim of this study was to evaluate the effectiveness and application of supermicrosurgery in free flap surgery. Materials and Methods: A total of 267 patients with soft tissue defects of the lower extremity due to various etiologies from January, 2007 to January, 2013. The patients received either an anterolateral thigh free flap (n=83), a superficial circumflex iliac artery free flap (n=152), an upper medial thigh free flap (n=19), or a superior gluteal artery perforator free flap (n=13). Microanastomosis was performed using a perforator-to-perforator technique, either end-to-end or end-to-side. Results: The mean postoperative follow up period was eight months (range: one to 16 months) and flap loss occurred in 11 cases out of 267. All cases of flap loss occurred within two weeks of surgery due to either arterial insufficiency (n=5) or venous congestion (n=6). Conclusion: Supermicrosurgery enables the selection of the most efficient perforator for microanastomosis at the defect site. It also reduces the time required for dissection of recipient vessels, and reduces the possibility of injury to major vessels. Microsurgery using a vessel of less than 1 mm has been reported to increase the risk of flap failure; however, using the most advanced surgical tools and developing experience in the technique can produce success rates similar to those found in the literature.

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