@jtstranix@JeremyPowersMD@pallabc@ErezDayanMD@prsjournal As noted, The 3-2-1 is a surrogate for level and amount of trauma and in 1 and 2 need to respect the zone concept. These are ones where vein grafting and possibly distal vessels may help.
@shujashafqatmd@DrNikkiPhillips@jtstranix@prsjournal Muscle has a role. Very good for contouring to defects. Muscle alone is a little harder to monitor than fasciocutaneou so we take a skin padddle which helps with monitoring. #PRSJournalClub nznhhhbBb bñnnhbbbbbbyHGGVVGHUHYUOh
@jtstranix@ErezDayanMD@prsjournal Historically, the dogma was anastomoses outside the zone of injury and proximal. If the zone was big this usually required vein grafting. Vein grafting may still be necessary but distal vessels may do the trick. #Microsurgery#PRSJournalClub
@jtstranix@ErezDayanMD@prsjournal Agree. Don't overlook the distal vessels. If inline flow is intact and the vein appears soft with flow it may be an excellent option and easier to dissect. #PRSJournalClub
@JeremyPowersMD@jtstranix If the vessels reconstitute distally that at least means the patient has good distal vessel communication but still has a high force injury and higher risk of flap issues