Reconstruction of the Soft Tissue Defect of the Lower Leg by Distally Based Superficial Sural Artery Fasciocutaneous Island Flap Using Supercharged Vein

원위기저 도서형 천비복동맥 근막피판으로 하지 재건 시 과급정맥문합의 이용

  • Ha, Young In (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Choi, Hwan Jun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Choi, Chang Yong (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Yong Bae (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University)
  • 하영인 (순천향대학교 의과대학 성형외과학교실) ;
  • 최환준 (순천향대학교 의과대학 성형외과학교실) ;
  • 최창용 (순천향대학교 의과대학 성형외과학교실) ;
  • 김용배 (순천향대학교 의과대학 성형외과학교실)
  • Received : 2007.12.27
  • Published : 2008.03.10

Abstract

Purpose: Distally based superficial sural artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. Venous congestion is an area of considerable concern in distally based superficial sural artery fasciocutaneous flap and is one of the main reasons for failure, particularly when a large flap is needed. However, we could decrease these disadvantages by means of venous superdrainage. Methods: From June of 2006 to June of 2007, a total of two patients with soft tissue defects of lower one third of the leg underwent venous supercharging distally based superficial sural artery island flap transfer. The distal pivot point of this flap was designed at septocutaneous perforator from the peroneal artery of the posterolateral septum, which was 5 cm above the tip of the lateral malleolus. Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein and collateral vein to any vein in the area of the recipient defect site. Results: No venous congestion was noted in any of the two cases. No other recipient or donor-site complications were observed, except for minor wound dehiscence in one case. In 3 to 6 months follow-up, patients had minor complaints about lack of sensation in the lateral dorsal foot. Conclusion: The peroneal artery perforator is predictable and reliable for the design of a distally based superficial sural artery island flap. Elevation of the venous supercharging flap is safe, easy, and less time consuming. In conclusion, the venous supercharging distally based superficial sural artery island flap offers an alterative to free tissue transfer for reconstruction of the lower extremity.

Keywords

References

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