Distally based greater saphenous venoadipofascial-sartorius muscle combined flap with venous anastomosis

In reconstruction of the extremities, a distally based flap is useful for covering the distal parts. Distally based flaps are, however, prone to congestion in the peripheral part of the flap, followed by partial necrosis because of insufficient venous drainage caused by resistance of the venous valves. To rescue peripheral congestion of the distally based flap, venous anastomosis is effective so that the venous blood flows in the direction of the venous valve. We applied this idea to a patient who had skin defects around the knee after a wide resection of the skin tumor, and covered them with a distally based greater saphenous venoadipofascial-sartorius muscle combined flap. The whole area of the flap took well without congestion after anastomosis of the vein.