[Surgical treatment of congenital phlebectasias of lower extremities]

Congenital vascular malformations present a difficult therapeutic challenge. Phlebectasias are abnormally large veins found supra or/and subfascially most often involving lower extremities. There might be a communication with the arterial system or not. Asymptomatic and mildly symptomatic lesions do not require treatment. Absolute indications for treatment include hemorrhage, secondary ischemic complications, and congestive heart failure from arteriovenous shunting. Relative indications include pain, functional impairment, and cosmetic deformity, including limb asymmetry associated with extremity lesions. We present a surgical approach indicated for symptomatic patients for whom supportive measures do not provide relief of symptoms. It includes total excision of the involved skin and underlying fatty tissue with the abnormal vessels. A special device for obtaining a split skin graft is used and autotransplantation is performed.