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We herein report the case of a 65\u2010year\u2010old man presenting a recurrent UPS in his right upper thigh region. The patient received radical resection of the tumor and the remaining defect measured ~22\u2009cm\u2009\u00d7\u200918\u2009cm. A soft tissue functional reconstruction with lymphatic\u2010flow\u2010through pedicled postero\u2010medial thigh flap (PMT) was planned. A 24\u2009cm\u2009\u00d7\u200916\u2009cm flap was harvested in vertical fashion (vPMT), carefully preserving a superficial vein for the following lymphovenous anastomosis (LVA) at recipient site. The flap was then rotated and transferred to the defect area through a tunnel under the adductor longus muscle, and LVA was then performed between flap's additional venous pedicle and a nearby leaking lymphatic vessel. The postoperative course was uneventful and at 12\u2009months follow\u2010up no complications were encountered. No signs of lymphedema were reported. When dealing with the groin and upper thigh area, which is notably rich in lymphatic tissue, the possibility of prophylactically re\u2010route lymphatic fluid into the venous system by means of microsurgical anastomosis, lays in the thrilling possibility to prevent secondary lymphedema, instead of curing it. With the described technique, we achieved optimal functional and esthetic outcomes setting at zero both donor and recipient sites morbidity.<\/jats:p>","DOI":"10.1002\/micr.30971","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T09:36:27Z","timestamp":1664876187000},"page":"382-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The use of vertical postero\u2010medial thigh flap as lymphatic flow\u2010through flap for upper thigh defect reconstruction and lymphatic sequelae prevention in sarcoma surgery: A case report"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9066-0704","authenticated-orcid":false,"given":"Sara","family":"Calabrese","sequence":"first","affiliation":[{"name":"Department of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Meroni","sequence":"additional","affiliation":[{"name":"Department of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-9140","authenticated-orcid":false,"given":"Mario F.","family":"Scaglioni","sequence":"additional","affiliation":[{"name":"Department of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2458\/lymph.4653"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-864841"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23787"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2020.01.014"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2007.03.012"},{"issue":"12","key":"e_1_2_6_7_1","first-page":"1054","article-title":"The lymphatic wick","volume":"43","author":"Gillies H.","year":"1950","journal-title":"Proceedings of the Royal Society of Medicine"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/2000656X.2022.2039680"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.21980"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181ec1eef"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30246"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58040509"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30712"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(00)00016-4"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.05.022"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2020.08.001"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002912"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30971","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.30971","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30971","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T15:47:20Z","timestamp":1692719240000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.30971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,4]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1002\/micr.30971"],"URL":"https:\/\/doi.org\/10.1002\/micr.30971","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"type":"print","value":"0738-1085"},{"type":"electronic","value":"1098-2752"}],"subject":[],"published":{"date-parts":[[2022,10,4]]},"assertion":[{"value":"2022-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}