Single stage arteriovenous short saphenous loops in microsurgical reconstruction of the lower extremity

The short saphenous vein can be used "in situ" to create a temporary arteriovenous shunt for lengthening the recipient vessels of the injured limb in microsurgical reconstructions of the lower extremity. We report our results using this single-anastomosis turnover technique in three high-energy trauma patients who presented open tibial fractures associated with vascular injuries. The construction of the arteriovenous fistula provided arterial access and venous drainage to a free latissimus dorsi flap that was transferred to cover the soft tissue defect. In all three cases, this single stage procedure was successful; the flap survived and provided good long term results. The use of the ipsilateral small saphenous vein "in situ" for immediate arteriovenous loop formation may be of great value in complex lower leg reconstructions. It is a reliable adjunctive technique that provides healthy vessels to supply the free flap, permitting stable wound coverage and high rate of limb salvage.