{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T13:20:28Z","timestamp":1761312028631,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Lower extremity reconstruction is challenging because of its intricate anatomy and dynamic biomechanics. Although microsurgical free tissue transfer offers pivotal solutions to limited local tissue availability, vascular pedicle exposure after free tissue transfer is common. We evaluated a novel method of managing pedicle exposure after free tissue transfer using a reprocessed micronized dermal substitute. Ten patients who underwent lower-extremity reconstruction using free tissue transfer and micronized dermal substitute between January and December 2023 were retrospectively reviewed. When native tissue could not be closed over the pedicle, reprocessed micronized artificial dermal matrix (rmADM) was cut and stacked to protect and stabilize it. Epithelialization was achieved by secondary skin grafting or healing by secondary intention. Flap dimensions, recipient artery and vein, ADM size, time required for granulation tissue maturation and complete epithelialization, and flap outcomes were analyzed. The mean age was 55.80 \u00b1 20.70 years, and six patients (60%) were diabetic. The mean rmADM coverage area was 8.70 \u00b1 8.41 cm2, and the average time required for complete epithelialization was 50.89 \u00b1 14.21 days. Except for one total necrosis due to bypass graft failure, nine limbs were successfully salvaged. Application of rmADM offers numerous advantages, including vascular collapse prevention, moisture maintenance, granulation tissue growth promotion, and pedicle stabilization.<\/jats:p>","DOI":"10.3390\/bioengineering11030241","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T02:59:39Z","timestamp":1709175579000},"page":"241","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Managing Vascular Pedicle Exposure in Free Tissue Transfer Using a Reprocessed Micronized Dermal Substitute in Lower Extremity Reconstructions"],"prefix":"10.3390","volume":"11","author":[{"given":"Daheui","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 14647, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Hyeok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 14647, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4696-7837","authenticated-orcid":false,"given":"Min Suk","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 14647, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma Rhip","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 14647, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4713-333X","authenticated-orcid":false,"given":"Daiwon","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 14647, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3800-5494","authenticated-orcid":false,"given":"Jung Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 14647, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"679e","DOI":"10.1097\/PRS.0000000000010034","article-title":"Aesthetic considerations in extremity salvage and reconstruction","volume":"151","author":"Govshievich","year":"2023","journal-title":"Plast. 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