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Arterial splinting is a modification of the aortic aneurysm site wrapping technique performed in cardiothoracic surgery. In microsurgery, we modify the technique without completely wrapping the anastomosis site when angulation occurs, but only splinting it to decrease angulation of the arterial anastomosis caused by turbulence in the passage of blood flow and lengthening of the pedicle using a vein graft such as bridge between the recipient vessel and the flap pedicle. We present a case of resection of mandibular carcinoma and reconstruction with fascia lata tensor free flap that, 32 hours after surgery, suffered profuse bleeding due to avulsion of the arterial microanastomosis. We used 16 cm of the saphenous vein to reconstruct the tear in the arterial pedicle and lengthen it in order to decrease the tension in the microanastomosis of the recipient vessel and the pedicle of the free flap. After microanastomosis, angulation of the pedicle occurs and noticed a 10-second delay in capillary filling after needle puncture of the free flap. We reserved 4 cm of the vein graft to splinting the angulation site of the arterial microanastomosis with the vein graft, achieving a decrease in the angle of the microanastomosis and a capillary filling of 2 to 3 seconds, thus improving the perfusion of the free flap [ABSTRACT FROM AUTHOR]

Introduction: For a muscle can be considered as a candidate for a flap, it must has certain requirements in relation of its function, anatomy (situation and relationships) and the vascular pedicle. The aim of this work is the study of the anatomy of the proximal pedicle of the vastus lateralis muscle (MVL) relative to the anatomical basis of the surgical approach of proximal flap of muscle and in this way demonstrate that prior anatomical knowledge of muscle as the pedicles is necessary to perform the surgical procedure. Materials and methods: 21 lower limbs formolized 10% methodically dissected were used. One proceeded to inject colored latex Results: Of the 20 dissections performed, 17 (85% of cases) are Type A, 2 (10%) are Type B and 1 (5%) corresponds to Type C. Discussion: The origin of the vessels supplying the vascularization of MVL has great importance in making the approach and the lifting of the flap. However, it was not found in the literature percentages and anatomical descriptions of the different variants of origin, course and distribution of the arteries that make up the pedicles of MVL. Conclusion: Knowledge of the anatomy of vascular pedicle is of utmost importance for the design of a muscle flap. This study proposes the anatomical basis for the correct design, approach and subsequent acquisition of the vastus lateralis muscle flap. We found a constant distribution of the pedicles: 17 (85% of cases) compared to type B: 2 (10% of cases) and Type C: 1 (5% of cases) of origin, distribution and constant termination PPVL The origin of vascular branches to the sartorius, rectus femoris and vastus intermedius have an origin usually (Type A) in the descending branch of the lateral circumflex artery, it isimportant when considering the arc of rotation muscular flap. It is necessary to conduct a case study in relation to the arrival of the vascular pedicle of MVL in relation to specific anatomical landmarks. [ABSTRACT FROM AUTHOR]