{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T13:18:59Z","timestamp":1761311939219,"version":"3.37.3"},"reference-count":5,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:00:00Z","timestamp":1670889600000},"content-version":"vor","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the \u201changing\u201d free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the \u201changing\u201d pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the \u201changing\u201d pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.<\/jats:p>","DOI":"10.1055\/s-0042-1758635","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T05:46:12Z","timestamp":1670996772000},"page":"782-784","source":"Crossref","is-referenced-by-count":1,"title":["Extracorporeal Pedicles for Free Flap Reconstruction in Diabetic Lower Extremity Wounds"],"prefix":"10.1055","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1628-6157","authenticated-orcid":false,"given":"Alejandro R.","family":"Gimenez","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Lazo","sequence":"additional","affiliation":[{"name":"Hospital Especializado, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salomao","family":"Chade","sequence":"additional","affiliation":[{"name":"Hospital Especializado, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Fioravanti","sequence":"additional","affiliation":[{"name":"Hospital Especializado, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olimpio","family":"Colicchio","sequence":"additional","affiliation":[{"name":"Hospital Especializado, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Hospital Especializado, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernani","family":"Junior","sequence":"additional","affiliation":[{"name":"Hospital Especializado, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3685-6324","authenticated-orcid":false,"given":"Sarth","family":"Raj","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9660-0697","authenticated-orcid":false,"given":"Amjed","family":"Abu-Ghname","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3980-720X","authenticated-orcid":false,"given":"Marco","family":"Maricevich","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1097\/PRS.0000000000007644","article-title":"Amputation versus free flap: long-term outcomes of microsurgical limb salvage and risk factors for amputation in the diabetic population","volume":"147","author":"V S Kotha","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jdiacomp.2011.02.001","article-title":"The importance of limb preservation in the diabetic population","volume":"25","author":"K K Evans","year":"2011","journal-title":"J Diabetes Complications"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.bjps.2012.09.024","article-title":"Diabetic foot reconstruction using free flaps increases 5-year-survival rate","volume":"66","author":"T S Oh","year":"2013","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1002\/dmrr.2755","article-title":"Innovations in diabetic foot reconstruction using supermicrosurgery","volume":"32","author":"H S Suh","year":"2016","journal-title":"Diabetes Metab Res Rev"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1055\/s-0040-1714431","article-title":"Special considerations for diabetic foot reconstruction","volume":"37","author":"H P Suh","year":"2021","journal-title":"J Reconstr Microsurg"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1758635.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T06:17:24Z","timestamp":1670998644000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1758635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":5,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2022,12,13]]},"published-print":{"date-parts":[[2022,11]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1758635","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"type":"print","value":"2234-6163"},{"type":"electronic","value":"2234-6171"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}