Premium
Delayed distally based sural flap with temporary venous supercharging
Author(s) -
Fujiwara Masao,
Nagata Takeshi,
Matsushita Yuki,
Ishikawa Kayoko,
Yusuke Ohta,
Fukamizu Hidekazu
Publication year - 2013
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.22154
Subject(s) - medicine , venous congestion , surgery , ligature , microsurgery , vein
The distally based sural flap has become popular for reconstruction of the foot and leg. However, this flap often fails due to venous congestion. In this report, we developed a new modification of the distally based sural flap. The procedure comprised three stages. In the first stage, the flap was raised cephalad to the midpoint of the posterior aspect of the leg, involving reanastomosis of the short saphenous vein (SSV) at the proximal end of the flap. In the second stage, ligature of the SSV was performed. In the third stage, the entire flap was raised. We treated eight patients with the flap. All flaps survived completely. Duplex scanning indicated that venous drainage of the flap was provided by the tenuous venae comitantes (VCs) surrounding the SSV. Reanastomosis of the SSV may prevent rapid venous overloading of the VCs. Our new modification may be useful to avoid venous congestion. © 2013 Wiley Periodicals, Inc. Microsurgery 33:534–538, 2013.