The nutrient omentum free flap: Revascularization with vein bypasses and greater omentum flap in severe arterial ulcers Raymund E. Horch, MD, Thomas.

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Presentation transcript:

The nutrient omentum free flap: Revascularization with vein bypasses and greater omentum flap in severe arterial ulcers Raymund E. Horch, MD, Thomas Horbach, MD, Werner Lang, MD Journal of Vascular Surgery Volume 45, Issue 4, Pages 837-840 (April 2007) DOI: 10.1016/j.jvs.2006.11.049 Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 1 This circular lower leg ulcer in peripheral arterial disease, with exposure of ankle joint, did not sufficiently respond to several repeated débridements and treatment vacuum therapy. Journal of Vascular Surgery 2007 45, 837-840DOI: (10.1016/j.jvs.2006.11.049) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 2 Postoperative angiography shows (1) occlusive arterial disease with proximal vein bypass from groin to distal femoral segment, (2) end-end-anastomosis from proximal to distal sequential vein bypass connected to the distal peroneal artery (3) and epiploic vessels of greater omentum microsurgically connected to the distal part of the sequential vein graft. Journal of Vascular Surgery 2007 45, 837-840DOI: (10.1016/j.jvs.2006.11.049) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 3 A, Schematic illustration (1) of proximal vein bypass, (2) with end-end-anastomosis to distal sequential vein bypass to distal peroneal artery, and (3) vessels of the greater omentum microsurgically connected to the distal part of femoroperoneal sequential bypass. Main view, medial aspect; insert shows detailed view from the lateral side, with the omental epiploic artery connected to the distal bypass end-to-side and to the recipient autochthonous vein. B, Positioning of microsurgically anastomosed free omentum maius flap around circular lower leg ulcer and ankle joint. C, Long-term stable healing at the 3-year follow-up after sequential bypasses and microsurgical transplantation of omentum maius flap on left leg, anterior and oblique view. Journal of Vascular Surgery 2007 45, 837-840DOI: (10.1016/j.jvs.2006.11.049) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions