Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer
Introduction: The pedicle positioning in free tissue transfer is critical to its success. Long thin pedicles are especially prone to this complication where even a slight twist in the perforator can result in flap loss. Pedicles passing through the long tunnels are similarly at risk. Streaking the p...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2015-09-01
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| Series: | Indian Journal of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.173124 |
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| author | Aditya Aggarwal Hardeep Singh Sanjay Mahendru Vimalendu Brajesh Sukhdeep Singh Ashish Khare Umang Kothari Rakesh Kumar Khazanchi |
| author_facet | Aditya Aggarwal Hardeep Singh Sanjay Mahendru Vimalendu Brajesh Sukhdeep Singh Ashish Khare Umang Kothari Rakesh Kumar Khazanchi |
| author_sort | Aditya Aggarwal |
| collection | DOAJ |
| description | Introduction: The pedicle positioning in free tissue transfer is critical to its success. Long thin pedicles are especially prone to this complication where even a slight twist in the perforator can result in flap loss. Pedicles passing through the long tunnels are similarly at risk. Streaking the pedicle with methylene blue is a simple and safe method which increases the safety of free tissue transfer. Materials and Methods: Once the flap is islanded on the pedicle and the vascularity of the flap is confirmed, the pedicle is streaked with methylene blue dye at a distance of 6-7 mm. The streaking starts from the origin of the vessels and continued distally on to the under surface of flap to mark the complete course of the pedicle in alignment. The presence of streaking in some parts and not in rest indicates twist in the pedicle. Observation and Results: Four hundred and sixty five free flaps have been done at our centre in the last 5 years. The overall success rate of free flaps is 95.3% (22 free flap failures). There has not been a single case of pedicle twist leading to flap congestion and failure. Conclusion: This simple and novel method is very reliable for pedicle positioning avoiding any twist necessary for successful free tissue transfer. |
| format | Article |
| id | doaj-art-23af4e24f64d4fb2bf46c64e6b3913a4 |
| institution | OA Journals |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2015-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-23af4e24f64d4fb2bf46c64e6b3913a42025-08-20T01:58:51ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2015-09-01480327427710.4103/0970-0358.173124Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transferAditya Aggarwal0Hardeep Singh1Sanjay Mahendru2Vimalendu Brajesh3Sukhdeep Singh4Ashish Khare5Umang Kothari6Rakesh Kumar Khazanchi7Department of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medanta - The Medicity, Gurgaon, Haryana, IndiaIntroduction: The pedicle positioning in free tissue transfer is critical to its success. Long thin pedicles are especially prone to this complication where even a slight twist in the perforator can result in flap loss. Pedicles passing through the long tunnels are similarly at risk. Streaking the pedicle with methylene blue is a simple and safe method which increases the safety of free tissue transfer. Materials and Methods: Once the flap is islanded on the pedicle and the vascularity of the flap is confirmed, the pedicle is streaked with methylene blue dye at a distance of 6-7 mm. The streaking starts from the origin of the vessels and continued distally on to the under surface of flap to mark the complete course of the pedicle in alignment. The presence of streaking in some parts and not in rest indicates twist in the pedicle. Observation and Results: Four hundred and sixty five free flaps have been done at our centre in the last 5 years. The overall success rate of free flaps is 95.3% (22 free flap failures). There has not been a single case of pedicle twist leading to flap congestion and failure. Conclusion: This simple and novel method is very reliable for pedicle positioning avoiding any twist necessary for successful free tissue transfer.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.173124free flapspedicleperforator |
| spellingShingle | Aditya Aggarwal Hardeep Singh Sanjay Mahendru Vimalendu Brajesh Sukhdeep Singh Ashish Khare Umang Kothari Rakesh Kumar Khazanchi Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer Indian Journal of Plastic Surgery free flaps pedicle perforator |
| title | Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer |
| title_full | Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer |
| title_fullStr | Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer |
| title_full_unstemmed | Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer |
| title_short | Pedicle streaking: A novel and simple aid in pedicle positioning in free tissue transfer |
| title_sort | pedicle streaking a novel and simple aid in pedicle positioning in free tissue transfer |
| topic | free flaps pedicle perforator |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.173124 |
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