{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T17:45:54Z","timestamp":1775238354926,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T00:00:00Z","timestamp":1662768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>For successful microsurgical reconstruction using free tissue transfer, healthy recipient vessels must be obtained from outside the zone of injury. Securing an appropriate length pedicle length is also essential, and various techniques for lengthening a vascular pedicle have been developed. Herein, we present our experience using the descending branch (DB) of the lateral circumflex femoral vessels (LCFVs) with a thigh flap as an extender graft for consecutive second flap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reconstructed the complex and vessel\u2010depleted defects of nine patients. The mean age was 47.6\u2009years. The defects were located in the lower leg in four patients, in the perineum in two patients and in the forearm in three patients. The two patients who suffered from Fournier's gangrene underwent a pedicled anteromedial thigh (pAMT) flap with the DB of the LCFVs and seven patients, five who suffered high\u2010energy trauma and two who had scar contracture, underwent a free anterolateral thigh (ALT) flap with the distal run\u2010off DB of the LCFVs. In all patients, second consecutive free latissimus dorsi or thoracodorsal artery perforator flaps were prepared and the thoracodorsal vessels of the second flap were anastomosed to the distal DB of the LCFVs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total length of the thigh flap pedicles measured from both ends of the DB of the LCFVs varied from 15 to 20\u2009cm, which was sufficient for use as a vascular conduit. Of the 18 flaps, 17 survived completely without any complications and 1 pAMT flap showed partial necrosis, which was covered with a perineal perforator\u2010based island flap. The mean follow\u2010up period was 16.7\u00a0months. Unfortunately, one patient, who suffered a total amputation below the knee and had replantation surgery, underwent amputation due to venous congestion in the distal leg. However, the previous two flaps survived and were used for coverage of the stump.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using a thigh flap as a vascular extender graft for second flap may be an alternative option in vessel\u2010depleted reconstructions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30958","type":"journal-article","created":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T08:46:06Z","timestamp":1662799566000},"page":"783-792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Resurfacing of lower extremities: Versatility of thigh flap as pedicle extension graft with consecutive thoracodorsal artery perforator\u2010based flap"],"prefix":"10.1002","volume":"42","author":[{"given":"Ji Seon","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Eunpyeong St. Mary's Hospital, College of Medicine Catholic University of Korea  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Joon","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, College of Medicine Hanyang University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Ah","family":"Park","sequence":"additional","affiliation":[{"name":"Design Lab of Technology Commercialization Center Industry\u2010University Cooperation Foundation of Hanyang University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3365-1232","authenticated-orcid":false,"given":"Youn Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, College of Medicine Hanyang University  Seoul South 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