Article
Pediculated suralis flap for closure of soft tissue defects of the lower leg
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Authors
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Arnold Suda
- Universitätemedizin Mannheim, Orthopädisch-Unfallchirurgisches Zentrum, Mannheim, Germany
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Juliane Mohr
- BG Klinik Tübingen, Klinik für Unfall- und Wiederherstellungschirurgie, Tübingen, Germany
| Published: | November 6, 2018 |
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Outline
Text
Objectives: Soft tissue defects of the lower leg mostly following open fractures, infection or post-operative wound healing problems can be closed with a pediculated fasciocutaneous sural flap. Aim of the study was to evaluate complications, risk factors for failure and the reason-ableness of this procedure.
Methods: 91 patients (92 flaps) were included in this retrospective study. Patient data was evaluated using patient's records and surgical reports. Co-morbidities and risk factors were noticed. At follow-up, patients were evaluated regarding soft tissue conditions, wound healing, pain, persistent infection and amility to walk. The patients had mean four surgical procedures before the flap, the follow-up was 13 months.
Results and conclusion: Only 40% of the patients received no Revision surgery, 71% of the flaps reached healing with maximum two revisions. Necrectomy and new meshgraft were main reasons for Revision. Long term complications were swelling or disturbance of sensitivity. We lost seven flaps, eight free flaps were necessary.
All patients with lost flaps showed relevant comorbidities. 71% of the flaps healed with maximum two revisions and the overall flap loss rate was 6%. The Advantages of this flap are short surgery time without the need of a microvascular anastomosis and a relatively simple surgical technique. The flap loss rate of 6% seems to be acceptable and, however, the flap isa good Option and an important step of the reconstructive ladder for soft tissue defect closure of the lower leg.
