title: The arterialized saphenous venous flow-through flap with dual venous drainage.
abstract: BACKGROUND
  Venous flow-through flaps are well-described options for small defects where donor site morbidity is undesirable or in areas where useful local veins are in close proximity to the defect, particularly in the extremities. However, higher rates of flap loss have limited their utility. The saphenous venous flap in particular has been widely sought as a useful flap, and while arterialization of this flap improved survival rates, congestion has remained a limiting feature. We describe report a modification in the design of saphenous venous flaps, whereby an arterialized flap is provided with a separate source of venous drainage, and demonstrate survival of substantially larger venous flaps than previously reported.
  
  
  METHODS
  In five consecutive patients, we describe three main modifications to the saphenous venous flap as previously described: (a) Using arterialized flaps only; (b) Reversing the flap to allow unimpeded flow during arterialization; and (c) Anastomosing additional vein(s) that are not connected to the central vein-especially at the periphery of the flap for true venous drainage.
  
  
  RESULTS
  There was a 0% complete flap loss rate (with only one case of superficial partial loss), and ultimately better survival than previous series of saphenous venous flaps described to date.
  
  
  CONCLUSIONS
  The success of these techniques offers the potential to re-establish flow to large segmental losses to axial arteries, offer safe and definitive flap coverage to traumatic wounds, improve the array of flap options in this setting, and minimize donor site morbidity.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, David St, Dandenong, 3175, Victoria Australia. warrenrozen@hotmail.com
authors.forename: Warren M
authors.initials: WM
authors.lastname: Rozen
authors.forename: Jeannette W C
authors.initials: JW
authors.lastname: Ting
authors.forename: Robert F
authors.initials: RF
authors.lastname: Gilmour
authors.forename: James
authors.initials: J
authors.lastname: Leong
mesh_terms: D000328:Adult; D001158:Arteries; D005260:Female; D005543:Forearm Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein; D013524:Surgical Flaps / Q000098:blood supply*; D014656:Vascular Surgical Procedures / Q000379:methods; D055815:Young Adult