A microneurovascular study of the great saphenous vein in man and the possible implications for survival of venous flaps

Nayak, Bibhuti Bhusan; Thatte, Ravin L.; Thatte, Mukund; Baliarsing, Amresh S.; Madhavan, Jagannathan; Pandit, Shobhna P.

doi:10.1054/bjps.1999.3217

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…Therefore, this limitation of venous flaps may lead some mistrust in some surgeons. On the other hand, lesser saphenous venofasciocutanous flap may not be solely a venous flap, as stated by Thatte and coworkers32 and Zhang et al33…”

Section: Discussionmentioning

confidence: 95%

Nerve sparing‐distally based sural flap

et al. 2011

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The management of soft-tissue defects in the ankle and foot area is a challenging task. Distally based sural flap is widely used, however it leaves donor area paresthesia. For this purpose, the sural nerve was dissected and preserved in the distally based sural flap in five cases of ankle and foot soft tissue reconstruction. This modification did not cause any compromise in flap circulation. All flaps survived with one partial distal necrosis. We suggest that, the distally based nerve sparing sural flap can be securely elevated with only a 3-4 cm wide subcutaneous pedicle without any compromise in flap circulation.

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Section: Discussionmentioning

confidence: 95%

Nerve sparing‐distally based sural flap

et al. 2011

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“…Thus, the blood supply and vessel axis of the greater saphenous neuro-venofasciocutaneous preforator flap were assured. 15,16 Some surgeons tend to preserve as much of the perforator as they can to guarantee the blood supply when attempting to rotate the flap. 17,18 However, in our clinical practice, we found that keeping more than one perforator may restrict further rotation and each of the pedicles may twist other perforators.…”

Section: Discussionmentioning

confidence: 99%

“…22 In our study series, we disconnected both the proximal and distal ends of the great saphenous vein and included it in the flap base, which avoided venous congestion that is caused by vein hypertension, while preserving the great saphenous vein as a vessel axis for the flap. Based on the literature, 14,16 the vascular network around the great saphenous vein is connected with veins that are accompanied by posterior tibial artery perforators, which is the flap outflow. However, ligation of the great saphenous vein distal end could avoid the physiological drainage from the great saphenous vein.…”

Section: Discussionmentioning

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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“…However, several recent articles that reported on the microanatomy of the vein wall and the perivenous tissues raised questions about the possible contribution of arterial input. 27,28 Saphenous veins harvested from amputated legs were shown to contain abundant vasa vasorum composed of arterioles, venules, and capillaries. The capillaries and arterioles were shown to increase in number, while proceeding from inside the vein wall to the surrounding perivenous tissues.…”

Section: Discussionmentioning

confidence: 99%

“…The central ear veins in the flaps were not assessed to investigate the contribution of minute arterioles to enhanced survival in the present study, since these findings have been reported in detail previously. [27][28][29] Few studies have particularly evaluated the use of pharmacologic agents in reducing ischemic tissue damage and the resultant partial/patchy necrosis in flowthrough venous flaps. Ueda et al 30 have effectively used the "delay" procedure to enhance flow-through venous flap survival.…”

Section: Discussionmentioning

confidence: 99%

Effects of Methylprednisolone on the Viability of Experimental Flow-Through Venous Flaps

Saray

Can²,

Sevin³

2002

J reconstr Microsurg

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In this study, the effects of a corticosteroid, methylprednisolone, on the survival of flow-through venous flaps were investigated in rabbits. Flow-through venous flaps, sized 3.0 x 4.5 cm, were raised in the rabbit-ear model. Animals were randomly distributed into three groups, and 30 flaps were raised as follows: Group 1 (n=10): control flow-through venous flaps (intramuscular saline injection 2 ml/d); Group 2 (n=10): flow-through venous flaps with daily intramuscular methylprednisolone injection (30 mg/kg/d); and Group 3 (n=10): negative control composite grafts with the flow-through vein ligated at both edges of the flap. All injections were done 24 hr and 1 hr preoperatively, and for 5 days postoperatively. Observations included gross and histologic examination, and percentage of survival of the flaps on the tenth day. Venous flaps of the animals receiving daily methylprednisolone injections (Group 2) were noted to have statistically significantly improved flap survival ( p<0.05), compared to the control group (Group 1). Flaps in Groups 1 and 2 demonstrated significantly higher survival rates, compared to the composite grafts ( p<0.01). Histologic examination of methylprednisolone-treated animals showed normal stratified squamous epithelium, while complete necrosis was noted in the composite grafts. Untreated flow-through venous flaps demonstrated patchy epidermal sloughing, crusting, and partial necrosis. These results suggest that the survival of potentially ischemic flow-through venous flaps can be enhanced in rabbits by daily methylprednisolone treatment in the perioperative period. Increased tolerance to ischemia and modulation of venous flap microcirculation might be possible mechanisms for this salutary effect.

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A microneurovascular study of the great saphenous vein in man and the possible implications for survival of venous flaps

Cited by 9 publications

References 9 publications

Nerve sparing‐distally based sural flap

Nerve sparing‐distally based sural flap

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

Effects of Methylprednisolone on the Viability of Experimental Flow-Through Venous Flaps

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