Reverse pedicle-based greater saphenous neuro-veno-fasciocutaneous flap for reconstruction of lower leg and foot

Kansal, Sandeep; Goil, Pradeep; Agarwal, Vijay; Agarwal, Swarnima; Mishra, Swati S.; Agarwal, Deepak

doi:10.1007/s00590-012-1150-5

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…8,9,14 This type of pedicle is bulky, and it tends to develop kinks and twists. In contrast, our flap was pedicled on the posterior tibial artery perforator vessels, which can provide a reliable blood supply to the flap and decrease the pedicle kinking and twisting occurrences.…”

Section: Discussionmentioning

confidence: 99%

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Single perforator greater saphenous neuro‐veno‐fasciocutaneous propeller flaps for lower extremity reconstructions

Zhong

Wang

et al. 2015

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

“…In clinical practice, the venous flow problem that is caused by venous hypertension was solved by including the segmental great saphenous vein into the flap base. [5][6][7][8] …”

Section: Introductionmentioning

confidence: 99%

Single perforator greater saphenous neuro‐veno‐fasciocutaneous propeller flaps for lower extremity reconstructions

Zhong

Wang

et al. 2015

ANZ Journal of Surgery

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“…6 Most authors prefer to use the perforator 5 cm proximal to the lateral malleolus as pivot point, as the higher the perforator, the longer the fascial pedicle and the flap needs to be based more proximally toward the popliteal crease. 12,16,17 However, the partial and complete flap necrosis rate is up to 36% especially in patients with other comorbidities, and surgical delay is often necessary to improve the success. 6,[8][9][10] In our modified surgical approach, we elevate the pivot point to approximately 7.5 cm proximal to the lateral malleolus, the aim of which is to preserve more perforators to perfuse the flap adequately.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of an Updated and Traditional Surgical Approach of the Distally Based Sural Flap

Cao²,

Kiu-Huen

et al. 2020

J Reconstr Microsurg

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Background The distally based sural flap (DBSF) is one of the armamentarium in the lower limb reconstruction. However, the flap has not gained popularity due to concerns about its reliability and donor site morbidity. Based on the anatomy characterization, we combined and developed five modifications to improve the vascular supply and reduce donor site morbidity. Patients and Methods The authors performed a comparison of retrospective study that included patients who underwent either traditional distally based sural flap (tDBSF) or modified distally based sural flap (mDBSF) surgery approach for ankle, heel, and dorsal foot coverage between January 2007 and May, 2019. The five modifications developed to improve the reliability of the flap include: 1. shift the pivot point more proximally 7.0 cm above the lateral malleolus, 2. preserve the lesser saphenous vein and include branches that communicates with the flap, 3. harvest thinner fascial pedicle, 4. change the skin incision to “S” shape, 5. closure of the donor site with a propeller flap. Results Thirty-one patients underwent mDBSF, and 23 received tDBSF. There were no significant differences in the size of the DBSF. Mean pedicle width was significantly narrower in mDBSF (1.63 ± 0.52 cm vs. 3.81 ± 0.70 in tDBSF). The pivot point was also found to be higher in mDBSF (8.01 ± 0.63 cm vs. 5.46 ± 0.56 cm) above the lateral malleolus. In mDBSF, the size of the propeller flap required for donor site closure was 53.45 ± 19.06 cm2 (range 33–80 cm2). The rate of partial necrosis between mDBSF and tDBSF was significantly different (9.68 vs. 34.78%). While the other complications had no difference. Conclusion The modifications applied to the harvesting of the DBSF have achieved higher survival rate, lower dehiscence rate, and shorter hospital stay time in comparison with traditional approach in our retrospective study.

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“…Délai traumatisme/ couverture : le délai de mise en place des lambeaux dans notre série est de 1 à 8 semaines. Ce délai retardé est rapporté dans d'autres séries en cas d'ostéite chronique [10, 12].…”

Section: Discussionunclassified

La couverture des pertes de substances cutanées du tiers inférieur de la jambe: à propos de 09 cas

Bensassi¹,

Elghadraoui²,

Zahraoui³

et al. 2019

Pan Afr Med J

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La couverture des pertes de substances cutanées du tiers inférieur de la jambe est compliquée, et ce dû à la pauvreté des tissus mous adjacents, la précarité de la vascularisation locale et l'exposition osseuse. Nous avons mené une étude rétrospective d'une série de 9 cas de couvertures cutanées du tiers distal de la jambe traitée au CHU Hassan 2 de Fès de l'année 2016 à 2018. L'objectif de notre étude est de relever la particularité des pertes de substances cutanées du tiers inférieur de la jambe, tout en soulignant la difficulté de couverture.

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Reverse pedicle-based greater saphenous neuro-veno-fasciocutaneous flap for reconstruction of lower leg and foot

Abstract: Reverse pedicle saphenous flap can be used to reconstruct defects of lower one-third leg and foot with a reliable blood supply with a large arc of rotation while having minimal donor site morbidity.

Cited by 11 publications

References 18 publications

Single perforator greater saphenous neuro‐veno‐fasciocutaneous propeller flaps for lower extremity reconstructions

Single perforator greater saphenous neuro‐veno‐fasciocutaneous propeller flaps for lower extremity reconstructions

A Retrospective Study of an Updated and Traditional Surgical Approach of the Distally Based Sural Flap

La couverture des pertes de substances cutanées du tiers inférieur de la jambe: à propos de 09 cas

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