Omentum Free XXXX Anastomosed to Arterial Bypass in Open Knee Dislocation: Case Report and Discussion.

@entity1 @entity455 @entity254 @entity1912 @entity715 @entity130
OBJECTIVE: To report on the original surgical management of a @entity1 with severe @entity130 of both legs involving @entity254 of an omentum free @entity1912 with an emergency vascular bypass. METHODS: After stabilization of the knee with an external fixator, a femoral-tibial bypass graft was performed to revascularize the leg with the contralateral great saphenous vein. Ten days later, an omentum free @entity1912 was used with an end-to-side arterial @entity254 between the right gastroepiploic artery and bypass graft to cover the loss of leg substance. DISCUSSION: @entity254 of a free @entity1912 with a single axis exposes the @entity1 to risks of @entity715 and amputation. Lengthening of the arterial pedicle of the @entity1912 by venous graft or vascular loop might have allowed for avoidance of connection to the bypass. Nevertheless, the saphenous vein, generally used in these indications, was already harvested. The transitional @entity254 of the @entity1912 to the contralateral leg could not be considered because of the leg amputation. End-to-side @entity254 to the bypass presents many advantages: @entity254 with a healthy vessel without @entity455 , the superficial characteristics of the bypass, and lower incongruence of the thickness between the vessels compared with an @entity254 performed directly on the superficial femoral artery. CONCLUSION: A free @entity1912 anastomosed to an emergency arterial bypass is a rare situation, which is not without risk, but it is an option that is justified by its technical simplicity. However, it should only be considered in exceptional circumstances.
