Retrograde Free Venous Flaps for Extremity Reconstruction: A Roadmap.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Vascular Surgery

Background:

• Retrograde free venous flaps are a distinct type of free venous flap with unclear physiology.
• They offer immediate visible refill and similar behavior to conventional flaps.
• Their potential applications and dimensions may be broader than previously thought.

Purpose of the Study:

• To evaluate the safety and efficacy of retrograde free venous flaps in complex reconstructions.
• To assess flap survival, complications, and functional outcomes.
• To investigate the potential of these flaps for customized tissue reconstruction.

Main Methods:

• A retrospective study of 31 retrograde free venous flaps performed between 2012 and 2019.
• Flaps were used for reconstruction of hands, digits, and one heel.
• Data collected included flap size, donor site, complications, survival rate, and functional outcomes.

Main Results:

• 31 patients underwent reconstruction with retrograde free venous flaps.
• All flaps, except two with complete necrosis, survived (93.5% survival rate).
• Two flaps experienced partial necrosis without requiring re-operation; no correlation with flap size was found.

Conclusions:

• Retrograde free venous flaps are a valuable tool for complex reconstructions of the hand and extremities.
• These flaps can provide large, pliable tissue islands, including tendons and nerves.
• Surgeons should be aware of potential complications and limitations associated with this technique.