The Role of Phlebotomy in the Prevention of Pedicled Sural Artery Flap Venous Congestion
Iraqi Postgraduate Medical Journal,
2021, Volume 20, Issue 4, Pages 399-405
The lower extremities defects considered one of the most challenging, lack of tissue, exposure of vital structure(bones, tendons, blood vessles, and nevers) make flap coverage is a must,Venous congestion is one of the common consequences in lower extremities flaps,Phlebotomy is one of the method to reduce venous congestion
To discuss the role of intravenous catheterization as a method of decreasing venous congestion in reverse flow Sural artery flap used for the reconstruction of lower limb defects.
Eight patients were treated at Alshadeed Ghazi Alharirie hospital for variable defects in lower limb during the period from January 2018 to April 2019 all treated with reverse Sural flap , the venous drainage of these flaps was enhanced by the addition of phlebotomy tube that was removed after the blood flow through it stops
A total of eight patients were included in this study with ages ranging from 30-62 years ( 7 males – 1 female ) cause of defects was trauma ( 5 cases ) , diabetic foot ulcer ( 2 cases ) , and post burn contracture release in one patient .
the site of the defect was heel (3 cases ) , ankle ( 2 cases ) , lower leg ( 2 cases ) and lateral malleolus (1 case ) . the size of the defect was ranging from 7*8 cm to 10*9 cm .all the flaps survived with no reported case of complete or partial flap necrosis , only one patient had mild skin necrosis of about 1 cm in width of distal margin of the flap which was held with secondary intention .
Intravenous catheterization of lesser saphenous is a simple and safe method for prevention of venous congestion of distally based Sural artery flap , intensive nursing care is needed and it is associated with less complications.
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