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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 February;50(1):39-46
Reverse saphenous flap. Personal experience of clinical use to treat loss of substance in the lower limbs
Bonaspetti G., Tassi M., De Filippo G., Megaro A., Pazzaglia U. E.
Background. Loss of substance in the lower limbs always presents difficult problems for reconstructive surgery. In this study the authors present the medial and lateral fasciocutaneous reverse saphenous flaps for the leg.
Methods. This flap was used in 27 patients attending the orthopedic clinic at Brescia University; mean follow-up was 24.4 months. Of these patients, 19 suffered from the sequelae of exposed fractures, 5 from osteomyelitis with exposure of the infection in the sequelae to exposed fractures, and 3, from flaying of the leg.
Results. No ischemic problems were reported following use of the flap; a neuroma of the internal saphenous nerve was observed in 2 cases, and recidivation of osteomyelitis in 1 case.
Conclusions. In the light of this experience, the authors affirm that this flap is easy to execute and can be used both during emergency surgery and in election. Given that it is a fasciocutaneous flap, it does not affect the muscular structures. On the contrary, during harvesting, if the donor zone is not closed by first intention, unattractive hollows may appear with skin dyschromia caused by the dermo-epidermal graft.