[Free latissimus dorsi flap revascularized by double venous graft on the femoral trifurcation in the treatment of lumbar radionecrosis. Apropos of 2 cases].

Two patients were operated in 1989 and 1992 for lumbar chronic osteoradionecrosis (toxi-infection collapsus in one of the two cases). Conventional coverage procedures (skin graft, local flaps) or distally based latissimus dorsi musculo-cutaneous flap (second case) were attempted but failed. So we realised in a one stage procedure a free musculo-cutaneous flap in the case no. 1 and a free muscular flap, later skin grafted, in the case no. 2. Venous and arterial bypass were provided by 40 cm long saphenous veins harvested from the thighs, and allowed to reach the lumbar site with proximal anastomosis performed on the femoral artery. The results were considered to be excellent. That short experience shows that long venous bypass with microsurgical free transfer can be safely performed. This results in an extremely high flow shunt.