The sartorius myocutaneous island flap.

The vascular supply to the distal part of sartorius m. was studied in 37 limbs by dissection under magnification and after black ink and latex injections. The muscle or myocutaneous island flap pedicled on the saphenous artery (SA) is supplied by a retrograde circulation through anastomoses of the SA with the perforating branches of the posterior tibial artery and the medial inferior genicular artery. Three different vascular patterns were defined. Retrograde injection also showed good perfusion of the SA. The flap is useful for covering around the knee, the proximal and middle thirds of the lower leg, and the end of the amputation stump. Raising of the flap has not resulted in any functional or cosmetic defect. Eighteen operations have so far been performed, six using the muscle island flap and twelve using the myocutaneous island flap, and all survived completely.