Clinical Case Experience Using Microsurgical Venous Flaps for Soft-Tissue Coverage of the Lower Extremity

ABSTRACT

Numerous venous flap models have been experimentally introduced and clinically attempted in reconstruction of soft-tissue defects. The authors report experience in soft-tissue coverage with microsurgical saphenous venous flap transfers in five patients with lower-extremity wounds. Four of these flaps failed postoperatively. Unhealthy recipient beds and inflamed veins were potential causes for these flap failures. Easy dissection without sacrifice of the artery would seem to provide an ideal situation for venous flap utilization, but this rate of failure prohibits recommendation of this flap in large, traumatic wounds.

KEYWORDS

Microsurgical venous flaps - soft-tissue defects - lower extremity

REFERENCES

• 1 Lineaweaver W C. The history of reconstructive microsurgery a conceptual approach.  SGH Proceedings . 1998;  7 36
• 2 Thatte M R, Thatte R L. Venous flaps.  Plast Reconstr Surg . 1993;  91 747-751
• 3 Baek S M, Weinberg H, Song Y. Experimental studies in the survival of venous island flaps without arterial inflow.  Plast Reconstr Surg . 1985;  75 88-95
• 4 Thatte R L, Thatte M R. A study of the saphenous venous island flap in the dog without arterial inflow using a non-biological conduit across a part of the length of the vein.  Br J Plast Surg . 1987;  40 11-15
• 5 Fukui A, Inada Y, Tamai S. Skin graft including subcutaneous vein: experimental study and clinical application.  J Reconstr Microsurg . 1988;  4 223-231
• 6 Amarante J, Costa H, Reis J, Soares R. Venous skin flaps: an experimental study and report of two clinical distal island flaps.  Br J Plast Surg . 1988;  41 132-137
• 7 Tsai T M, Matiko J D, Breidenbach W, Kutz J E. Venous flaps in digital revascularization and replantation.  J Reconstr Microsurg . 1987;  3 113-119
• 8 Honda T, Nomura S, Yamauchi S. The possible applications of a composite skin and subcutaneous vein graft in the replantation of amputated digits.  Br J Plast Surg . 1984;  37 607-612
• 9 Fukui A, Inada Y, Maeda M. Pedicled and “flow-through” venous flaps: clinical applications.  J Reconstr Microsurg . 1989;  5 235-243
• 10 Nakayama Y, Soeda S, Kasai Y. Flaps nourished by arterial inflow through the venous system: an experimental investigation.  Plast Reconstr Surg . 1981;  67 328-334
• 11 Ji S Y, Chia S L, Cheng H H. Free transplantation of venous network pattern skin flap: an experimental study in rabbits.  Microsurgery . 1984;  5 151-159
• 12 Thatte R L, Thatte M R. Cephalic venous flap.  Br J Plast Surg . 1987;  40 16-19
• 13 Chavoin J P, Rouge D, Vachaud M. Island flaps with an exclusively venous pedicle. A report of eleven cases and a preliminary haemodynamic study.  Br J Plast Surg . 1987;  40 149-154
• 14 Foucher G, Norris R W. The venous dorsal digital island flap or the “neutral” flap.  Br J Plast Surg . 1988;  41 337-343
• 15 Thatte R L, Thatte M R. The saphenous venous flap.  Br J Plast Surg . 1989;  42 399-404.
• 16 Davies D M. A world survey of anticoagulation practice in clinical microvascular surgery.  Br J Plast Surg . 1982;  35 96-99
• 17 Gencosmanoglu R, Yim K, Lineaweaver W C. Comparison of arterialized venous muscle flap and arteriovenous flow reversal flap in a rat model. In: Carraro U, Salmon S eds. Basic and Applied Myology: Perspectives for the 90's Padova, Italy: Unipress 1991 : 379-389