Research Article

Lower Extremity Salvage with Thoracodorsal Artery Perforator Free Flap in Condition of Symmetrical Peripheral Gangrene

Table 1

Summary of patient characteristics.

Gender/ageShock stateVasopressorUnderlying diseaseInvolved regionAmputation levelType of flapFlap size (cm)Pedicle length (cm)Recipient vesselsDonor siteEarly complicationsLate complicationsAmbulation
(FAC)
Follow-up
(month)

M/44Septic shockEpinephrineHTN, DMFeet, bothTransmetatarsal amputation, Rt.TDAP7 × 117ATA, AVPrimary closureNone618

M/46Respiratory arrestEpinephrineHTN, DMFeet, both hands, bothTransmetatarsal amputation, Rt.TDAP8 × 1010PTA, AVPrimary closureNone612
Transmetatarsal amputation, Lt.TDAP, STSG9 × 1110PTA, AVPrimary closureNone

M/60Hypovolemic shockDopamineAortic dissection
(Aorto-bi-iliac bypass graft state)
Foot, Rt.Lisfranc amputation, Rt.TDAP8 × 128ATA, AVPrimary closureNoneChronic ulcer554

F/60Septic shockNorphinHTN, DM, ESRD, CHF, PTEFeet, bothLisfranc amputation, Rt.TDAP & LDm9 × 127ATA, AVPrimary closurePartial necrosis412
(Chimeric)(4 × 4)
Transmetatarsal amputation, Lt.TDAP20 × 127PTA, GSVSTSG coverageNone

F/57Septic shockDopamineHTN, DMFeet, both hands, bothTransmetatarsal amputation, Rt.TDAP20 × 157PTA, AVSTSG coveragePartial necrosis, STSG46
Transmetatarsal amputation, Lt.TDAP25 × 1511ATA, AVSTSG coverageNone

F/69Septic shockNorphinHTN, DMFeet, bothTransmetatarsal amputation, Rt.TDAP15 × 107ATA, AVPrimary closureNoneChronic56
Transmetatarsal amputation, Lt.TDAP, STSG25 × 1511PTA, AVSTSG coveragePartial necrosisOsteomyelitis

HTN: hypertension; DM: diabetes mellitus; ESRD: end-stage renal disease; CHF: congestive heart failure; PTE: pulmonary thromboembolism; TDAP: thoracodorsal artery perforator; ATA: anterior tibial artery; PTA: posterior tibial artery; AV: accompanying vein; GSV: greater saphenous vein; STSG: split thickness skin graft; OM: osteomyelitis.