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Use of flap based on anterior tibial artery for free transfer.

Free flap transfer can be a challenge because of the risk of anastomotic failure, especially in microvascular tissue transfers. Free lateral crural flap based on the anterior tibial artery has good vascular condition that results in a low rate of failure. To avoid loss of the anterior tibial artery of the donor, we reconstructed the anterior tibial artery after the flap was harvested with a "half-half" technique in a simple way. Ten patients underwent this type of flap transfer and succedent artery reconstruction. All flaps survived. In no case was a subsequent anastomosis thrombosis operation required. Donor site morbidities were negligible. By contrast, the vessels of the free lateral crural flap were in better condition than that of other flaps. The flap can be used reliably and successfully without loss of the major artery trunk. We believe that the flap has special characteristics that may be useful in selected instances.