American Society of Hirudotherapy

Transposition flap and skin graft techniques for optimizing anastomosis coverage

Research article published in ANZ journal of surgery (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsHa et al. · ANZ journal of surgery, 2025

Abstract

BACKGROUND: This study explores a novel technique combining transposition flaps with Split-Thickness Skin Grafts (STSG) to enhance anastomosis site coverage in free tissue transfer surgeries, particularly in lower limb reconstructions using Thoracodorsal Artery Perforator (TDAP) free flap procedures. This method aims to alleviate tension at the anastomosis sites, a common issue affecting reconstructive surgery success. METHODS: A retrospective analysis was conducted on 20 patients who underwent TDAP free flap procedures. These cases were chosen due to the anticipated tension at anastomosis sites, necessitating the use of transposition flaps and STSG. Surgical procedures were meticulously documented, and postoperative outcomes were monitored, focusing on complications and overall surgical success. RESULTS: The study found no instances of complete flap failure, indicating the potential efficacy of the combined approach. Minor complications included two cases of partial tip necrosis in the transposition flaps and two cases of partial graft loss in the STSGs. These issues were resolved through secondary intention healing, demonstrating the technique's ability to manage minor postoperative challenges and maintain flap viability. CONCLUSION: Integrating transposition flaps with STSG significantly improves tension management at anastomosis sites in TDAP free flap procedures. This technique not only reduces immediate postoperative complications but also supports the long-term success of reconstructive surgeries. The findings advocate for further research to confirm the efficacy of this approach in microsurgical applications, aiming to enhance patient outcomes and advance reconstructive microsurgery.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsHumansRetrospective StudiesMaleMiddle AgedFemaleAnastomosis, SurgicalSkin TransplantationAdultPlastic Surgery ProceduresFree Tissue FlapsAgedTreatment Outcome

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This retrospective series of 20 patients undergoing thoracodorsal-artery-perforator free-flap lower-limb reconstruction described combining transposition flaps with split-thickness skin grafts to reduce tension at anastomosis sites, reporting no complete flap failures and only minor complications (two partial tip necroses, two partial graft losses) that healed by secondary intention. For ASH this is relevant because flap and replantation surgery is the principal modern clinical setting where medicinal leeches are used to relieve venous congestion and salvage compromised tissue, so techniques that improve flap viability define the field hirudotherapy supports. It is a small, single-arm retrospective series without a comparison group and does not involve leech therapy, so its surgical conclusions are preliminary and the leech connection is contextual.

Citation

Transposition flap and skin graft techniques for optimizing anastomosis coverage.

Ha et al. · ANZ journal of surgery, 2025

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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