Reverse-flow posterior tibial island flap: preliminary report of a new fasciocutaneous flap.

Abstract

Septocutaneous vessels constitute an important source of skin circulation in the leg and form the basis of various fasciocutaneous flaps that have useful clinical applications. In 1978, Goufan and Baogui described a flap from the forearm based on the radial artery (Chinese forearm flap). With this in mind, the reverse-flow posterior tibial fasciocutaneous flap (Thai leg flap, or TLF) was designed and successfully transferred clinically to cover lower leg and foot defects in 2 patients. The factors that permit a distally based flap to be raised in the lower leg against the direction of the venous valves, and the backflow of arterial blood, are also described. The versatility, advantages, and disadvantages of this new flap in the reconstruction of defects of the lower leg and foot are discussed.