Selecting an appropriate recipient vessel is the most important factor for successful free flap transfer in the reconstruction of severe lower extremity trauma. In this study, the relationship between the choice or status of the recipient vessel and the incidence of complications, such as flap failure, intraoperative vasospasm due to post-traumatic vessel disease (PTVD) , and early revision surgery, was investigated for 34 flaps in 32 patients who underwent microsurgical soft tissue reconstruction.
The choice of recipient vessel (posterior tibial artery［PTA］vs anterior tibial artery［ATA］) and whether an injured vessel was used as a recipient vessel did not significantly affect the complication rate if the vessel was used within a few days from the day of injury.
Therefore, the PTA or the ATA can be used as a recipient vessel depending on the technical convenience of the surgery, and avoiding injured vessels is not necessary if the operation is performed within a few days after injury. To prevent vasospasm due to PTVD, the recipient vessel must be anastomosed as far as possible from the zone of injury and the surgery must be performed as early as possible after the day of injury.
