{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:42:22Z","timestamp":1792024942321,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T00:00:00Z","timestamp":1487894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim is to describe a technique with orthograde dissection of the anterior tibial artery (ATA) used as the recipient vessel for the end\u2010to\u2010end (ETE) anastomosis in defect reconstruction around the knee and for proximal\/middle third leg defects with free anterolateral thigh (ALT) and gracilis flaps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Between March 2009 and May 2014, 22 patients undergoing lower extremity reconstruction were evaluated. Of those, 4 patients were included. The locations of injury were 3 defects around the knee and 1 defect at the proximal and middle third of the lower leg (mean defect size 18 x 8.5 cm and a range of 17\u201020 x 5\u201010 cm). There were 2 cases after trauma and 2 cases with infection. Two free gracilis and 2 free ALT flaps were performed of equal size to the defects. The mean flap pedicle length was 11 cm (range of 7\u201316 cm) and the mean length of the mobilized recipient vessels was 10.5 cm (range of 6\u201314 cm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One flap loss (ALT) occurred, requiring a salvage procedure with a latissimus dorsi flap, whereas wound dehiscence at the donor site and a hematoma below the ALT flap was observed in 2 cases, requiring small revision. After a mean follow\u2010up of 52 months (range of 38\u201387 months), there was stable soft tissue coverage in all patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>By orthograde dissection of the ATA, an adequate vessel length and size may be achieved, improving arc of rotation to successfully cover more distant defects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30163","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T10:38:32Z","timestamp":1487932712000},"page":"60-65","source":"Crossref","is-referenced-by-count":6,"title":["Extending the limits of the anterior tibial artery as the recipient vessel for around the knee and proximal lower extremity defect reconstruction using the free anterolateral thigh and gracilis flap"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6593-9690","authenticated-orcid":false,"given":"Mathias","family":"Tremp","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery University Hospital Basel Basel 4031 Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth A.","family":"Kappos","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery University Hospital Basel Basel 4031 Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo M.","family":"Oranges","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery University Hospital Basel Basel 4031 Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro G.","family":"di Summa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery University Hospital of Lausanne Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J.","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery University Hospital Basel Basel 4031 Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto","family":"Wettstein","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery University Hospital Basel Basel 4031 Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel F.","family":"Kalbermatten","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery University Hospital Basel Basel 4031 Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30016"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199407000-00026"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000297634.53915.e5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.1920150514"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-016-0427-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1563397"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197308000-00001"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-198510000-00013"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198609000-00002"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198609000-00001"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197964050-00013"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.1920160703"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2013.40.5.575"},{"key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/S0094-1298(20)30795-1","article-title":"Avoiding free flap failure","volume":"19","author":"Khouri R. 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