title: Reverse pedicle-based greater saphenous neuro-veno-fasciocutaneous flap for reconstruction of lower leg and foot.
abstract: BACKGROUND
  Paucity of soft tissue available locally for reconstruction of defects in leg and foot presents a challenge for reconstructive surgeon. The use of reverse pedicle-based greater saphenous neuro-veno-fasciocutaneous flap in reconstruction of lower leg and foot presents a viable alternative to free flap and cross-leg flap reconstruction. The vascular axis of the flap is formed by the vessels accompanying the saphenous nerve and the greater saphenous vein. We present here our experience with reverse saphenous neurocutaneous flap which provides a stable cover without the need to sacrifice any important vessel of leg.
  
  
  METHODS
  The study is conducted from March 2003 through Dec 2009 and included a total of 96 patients with defects in lower two-thirds of leg and foot. There are 74 males and 22 females. Distal pivot point was kept approximately 5-6 cm from tip of medial malleolus, thus preserving the distal most perforator, and the flap is turned and inserted into the defect. Donor site is covered with a split thickness skin graft. Postoperative follow-up period was 6 weeks to 6 months.
  
  
  RESULTS
  The procedure is uneventful in 77 cases. Infection is observed in 14 cases. Partial flap necrosis occurs in 2 cases. Total flap necrosis is noted in 3 cases.
  
  
  CONCLUSIONS
  Reverse pedicle saphenous flap can be used to reconstruct defects of lower one-third leg and foot with a reliable blood supply with a large arc of rotation while having minimal donor site morbidity.
authors: , A-27, Alok Park, Modinagar, 201204, Ghaziabad, UP, India, drsandeepkansal@gmail.com.
authors: Sandeep
authors: S
authors: Kansal
authors: Pradeep
authors: P
authors: Goil
authors: Vijay
authors: V
authors: Agarwal
authors: Swarnima
authors: S
authors: Agarwal
authors: Shashank
authors: S
authors: Mishra
authors: Deepak
authors: D
authors: Agarwal
authors: Pranay
authors: P
authors: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D005206:Fascia Lata / Q000601:surgery*; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D007866:Leg / Q000601:surgery; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012501:Saphenous Vein / Q000601:surgery* / Q000637:transplantation; D016038:Skin Transplantation; D016896:Treatment Outcome; D055815:Young Adult