[The clinical application of distally based neurocutaneous flaps by anastomosis of superficial veins].

OBJECTIVE

To investigate the clinical results of the distally based neurocutaneous flap by anastomosis of superficial veins.

METHODS

From June 1996, 19 cases with composite skin defects of the distal part of limb were repaired by the transposition of distally based neurocutaneous flaps, including traumatic defect in 10 cases, chronic ulcer in 3 cases, scar contracture in 6 cases. The distally based sural neurocutaneous flaps were used in 9 cases, the reverse-flow saphenous neurocutaneous island flaps were used in 2 cases, and the retrograde neurocutaneous island flaps of the forearm were used in 8 cases. The flap area ranged from 15 x 24 cm to 4 x 6 cm, the pedicle of the flap ranged from 6 cm to 15 cm in length. The superficial vein of the flap were anastomosed with the subcutaneous superficial vein of the recipient site to improve the venous drainage.

RESULTS

The composite flap survived completely in 17 cases. One cases with retrograde-flow forearm neurocutaneous flap and another case with reversed sural neurocutaneous flap were partially survived because of thrombosis in anastomosed veins postoperatively. Sixteen cases were followed-up for 6 to 24 months, the color and texture of the flap were excellent, the protective sensation were recovered, the configuration and function were satisfactory.

CONCLUSION

Anastomosis of superficial veins of the composite flaps with the subcutaneous superficial veins of the recipient site can significantly improve the venous drainage, enlarge the survival area of the flap and the reparable area.