2011 年 24 巻 4 号 p. 345-350
From 1996 to 2008, 161 patients (120 men and 41 women; 3 to 80 years old) with traumatic skin defect, nonunion, or osteomyelitis were treated with free vascularized composite tissue grafts. The lesions affected the upper limb in 100 out of the 161 patients and the lower limb in 61. Free grafts were raised from a variety of donor sites; the most common grafts were the peroneal flap or fibular graft (n=56), scapular flap or scapular graft (n=41), and lateral upper arm flap (n=11). Postoperative thrombosis of anastomotic vessel necessitated reexploration in 13 patients. In 4 of the 13 patients, the flaps could not be salvaged. The most common cause of the thrombosis was that the anastomotic vessel was compressed by a hematoma and / or hemorrhage. The incidence of this complication was significantly higher in the cases where the free vascularized composite graft was transferred to the lower limb.