The Saphenous Neurovascular Free Flap

Abstract

A new neurovascular free-flap donor area on the medial side of the [human] knee is described. The flap is supplied by the saphenous artery, a branch of the descending genicular artery. It is drained by the long saphenous vein and by the saphenous venae comitantes. Its nerve supply is from the medial femoral cutaneous nerve above the knee and the saphenous nerve below the knee. The flap is thin, has a long vascular pedicle (up to 15 cm) and a dependable nerve supply, and can be made quite large. The principal disadvantage is the donor wound, which requires grafting in most cases. Anatomy of the saphenous flap, method of raising it, and clinical experience with it as a free flap and as a pedicled flap are described. Potential uses of the saphenous flap and its broader significance in relation to flaps on the lower extremity are discussed.