Settembre Nicla, D'oria Mario, Dekerle Lucie, Saba Charbel, Bouziane Zakariyae, Malikov Serguei
Department of Vascular Surgery, Nancy University Hospital, University of Lorraine, Nancy, France; INSERM 1116, University of Lorraine, Nancy, France.
Department of Vascular Surgery, Nancy University Hospital, University of Lorraine, Nancy, France.
Ann Vasc Surg. 2018 Aug;51:327.e9-327.e13. doi: 10.1016/j.avsg.2018.02.048. Epub 2018 Jun 12.
Venous malformations are the most common slow-flow vascular malformations; they are not prone to volume decrease over time, and invasive treatment is usually required. There are 2 main techniques to address the definitive therapy of these lesions, sclerotherapy and surgical excision, each with its own advantages and disadvantages. We report the case of a 56-year-old man who came to our attention with persistent pain after multiple unsuccessful attempts to treat a large venous malformation located in the area of the right knee. After radical excision of the painful lesion, we covered the resulting major tissue loss (20 cm × 15 cm) with a free omental flap. The arterial and venous anastomoses were on the region above the knee pedicles. The postoperative course was uneventful. A secondary skin grafting was performed. The patient is doing well at 1-year follow-up. The omental flap may be a bailout solution for tissue loss coverage in the knee area when the use of the common fascia-cutaneous or muscular flaps is not possible.
