title: Use of a sequential two-in-one free arterialised venous flap for the simultaneous reconstruction of two separate defects on the foot.
abstract: 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.
authors.affiliation: Department of Plastic Surgery, En Chu Kong Hospital, No. 399 Fu-Shin Road, San Shia, Taipei, Taiwan, ROC.
authors.forename: Tai-Ju
authors.initials: TJ
authors.lastname: Cheng
authors.forename: Yo-Shen
authors.initials: YS
authors.lastname: Chen
authors.forename: Yueh-Bih
authors.initials: YB
authors.lastname: Tang
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001158:Arteries; D003444:Crush Syndrome / Q000601:surgery*; D018409:Foot Injuries / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply