Cheng Tai-Ju, Chen Yo-Shen, Tang Yueh-Bih
Department of Plastic Surgery, En Chu Kong Hospital, No. 399 Fu-Shin Road, San Shia, Taipei, Taiwan, ROC.
Br J Plast Surg. 2004 Oct;57(7):685-8. doi: 10.1016/j.bjps.2004.06.005.
A sequential free arterialised venous flap carrying two flaps nourished by a single venous pedicle was designed for the simultaneous reconstruction of two separate soft tissue defects on the dorso-medial aspect of the foot. These two defects were separated by approximately 3.5 cm, exposing the extensor hallucis longus tendon and first tarso-metatarsal joint. Superficial epidermolysis was noted postoperatively in the smaller flap. Nonetheless, flap survival was uneventful with no further surgery required, and the patient was discharged 7 days after surgery. Three months after the surgery, the patient was satisfied with the result and no morbidity was evident at the donor site. The sequential flap is not a new flap category, but we are unaware of any previous report of a free arterialised venous flap in the form of a sequential flap. We demonstrate the clinical value of this type of flap design for selected cases. The benefits and possible pitfalls of the sequential free arterialised venous flap are discussed.
