{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T22:45:14Z","timestamp":1775947514184,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Non-healing soft tissue defects pose challenges to treating physicians. Microsurgical reconstruction is a treatment option for achieving wound closure and limb salvage. These free tissue transfers are often challenging due to associated risk factors. This study aimed to evaluate microsurgical reconstruction using specialized microsurgical techniques for non-healing spontaneous or post-traumatic soft tissue defects in an elderly, high-risk patient cohort with peripheral artery disease. Methods: A retrospective study was conducted on patients with radiologically confirmed peripheral artery disease who underwent free tissue transfers between 2004 and 2010. Patients were included in whom one of two surgical techniques was used, including a \u201cY\u201d configuration of the arterial pedicle, employed either as an interposition graft or as an arterial patch, or the use of a saphenous vein graft. Patient demographics, comorbidities, flap\/limb survival, and surgical techniques were analyzed. Results: Twenty patients at a mean age of 68 (+\/\u22129.3) years underwent 21 primary flap surgeries. Trauma-derived soft tissue defects were predominant (55%). Latissimus dorsi muscle flaps were most frequently utilized (52.4%). The flap success rate was 90.5% at a 12-month follow-up, with no secondary amputations recorded. The lost flaps were replaced by additional free tissue transfers without further complications. Conclusions: This study demonstrates the feasibility of free tissue transfers in high-risk patients with complex soft tissue defects and vascular calcifications. Thorough preoperative planning and the application of specialized surgical techniques are crucial for favorable outcomes in challenging clinical scenarios.<\/jats:p>","DOI":"10.3390\/jcm14010157","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T07:00:37Z","timestamp":1735628437000},"page":"157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cY\u201d Configuration of the Arterial Pedicle or the Use of a Saphenous Vein Graft for Microsurgical Reconstruction in the Old and Diseased\u2014A Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0960-5836","authenticated-orcid":false,"given":"Maximilian","family":"Moshammer","sequence":"first","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"COREMED\u2014Centre for Regenerative Medicine and Precisions Medicine, Neue Stiftingtalstrasse 2, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-9891","authenticated-orcid":false,"given":"Andrzej","family":"Hecker","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"COREMED\u2014Centre for Regenerative Medicine and Precisions Medicine, Neue Stiftingtalstrasse 2, 8010 Graz, Austria"},{"name":"Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, Merseburger Strasse 165, 06112 Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4919-7006","authenticated-orcid":false,"given":"Nikolaus","family":"Watzinger","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"COREMED\u2014Centre for Regenerative Medicine and Precisions Medicine, Neue Stiftingtalstrasse 2, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9785-5480","authenticated-orcid":false,"given":"Anna-Lisa","family":"Pignet","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"COREMED\u2014Centre for Regenerative Medicine and Precisions Medicine, Neue Stiftingtalstrasse 2, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0248-537X","authenticated-orcid":false,"given":"Ron","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, Merseburger Strasse 165, 06112 Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerlinde","family":"Weigel","sequence":"additional","affiliation":[{"name":"Austrian Armed Forces, Medical Center East, Medical Facility Vienna, 1210 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5975-876X","authenticated-orcid":false,"given":"Lars-Peter","family":"Kamolz","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"COREMED\u2014Centre for Regenerative Medicine and Precisions Medicine, Neue Stiftingtalstrasse 2, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2559-1459","authenticated-orcid":false,"given":"Werner","family":"Girsch","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1020","DOI":"10.1016\/S2214-109X(19)30255-4","article-title":"Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: An updated systematic review and analysis","volume":"7","author":"Song","year":"2019","journal-title":"Lancet Glob. 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