Long saphenous vein grafts as an aid to microsurgical reconstruction of the trunk

The authors describe a method of closing truncal defects using free-tissue transfer when neither local tissue or vascular access are available. The long saphenous vein is dissected free as far distally as necessary and turned up, leaving its upper drainage intact. The distal end is then anastomosed to the femoral artery to create a temporary arteriovenous loop. After placing an appropriate free flap in the defect, the A-V loop is divided and used to provide both arterial supply and venous drainage for the flap. Anatomy, technique, and representative cases in which this method has been used for closing traumatic tissue defects of the trunk are presented and discussed.