The venous flap - a safe alternative to the simple vein graft in a special situation

The use of free tissue transfer has evolved to become the mainstay of treatment of tissue defects. The reconstructive surgeon can choose from a wide variety of flaps. Flaps are chosen based on the tissue defect and also on the characteristics of the pedicle in terms of calibre and vessel length. Occasionally situations arise necessitating the use of vein grafts. Vein grafts can be used primarily as part of a planned procedure to increase pedicle length or as a salvage technique following anastomotic complication. We report the use of venous flap instead of a conventional vein graft, for restoring continuity of the arterial flow in the pedicle of a free flap, following resection of a thrombosed segment. A venous flap harvested from the left leg with a cutaneous vein was used in a flow-through fashion to restore the continuity of the arterial inflow to the flap. The venous flap is an ideal option in selected cases instead of a vein graft. This is specifically indicated where there is a shortage of soft tissue to cover the anastomosis. The pedicle can then be covered in a tension-free manner. Thus in addition to extremity wounds, the venous flap can be used safely in salvage of difficult situations in the head and neck area.