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Abstract

ABSTRACT: BACKGROUND: 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 OBJECTIVE: 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. METHOD: 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 RESULTS: 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 . CONCLUSION: 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.    

DOI

10.52573/ipmj.2020.170487

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