Microscopic retrograde great saphenous vein supercharged anastomosis to address propeller flap congestion in lower limb defect reconstruction: A case report.

INTRODUCTION

Reconstructing defects in the lower limb can be challenging when local flaps cannot be used. Free flaps are a good alternative, but they take more time. Free flaps may also fail in inflamed areas because veins can be damaged by inflammation.

CASE PRESENTATION

We report a 35-year-old man with a severe leg and ankle injury. We treated his defect with a propeller flap that included the great saphenous vein, clipped at its proximal end. After moving the flap over the wound, the clipped end of the saphenous vein was directed toward the ankle. We then connected this clipped end to a deep vein in the ankle by a retrograde end-to-end anastomosis. This was done to prevent venous congestion and improve venous drainage.

DISCUSSION

Propeller flaps based on perforator vessels can substitute for free flaps when other local flaps are unavailable. However, propeller flaps often have venous congestion as a complication. Performing a venous supercharging anastomosis, even in a retrograde manner, can help reduce this congestion.

CONCLUSION

Propeller flaps are an excellent option for lower limb reconstruction. A microscopic retrograde anastomosis of the great saphenous vein can effectively prevent venous congestion.