Comparative study of two types of distally based sural neurocutaneous flap for reconstruction of lower leg, ankle, and heel

J Reconstr Microsurg. 2013 Feb;29(2):125-30. doi: 10.1055/s-0032-1329926. Epub 2012 Dec 31.

Abstract

Background: Soft-tissue defects in the lower leg, ankle, and heel often require reconstruction with local or free flaps. We try to compare the clinical outcome and complications following transfer of a perforator pedicle-based sural neurocutaneous flap (P-NCF) or a fascia pedicle-based sural neurocutaneous flap (F-NCF).

Methods: Between March 2007 and December 2010, 92 patients (mean, 36.52 years) with a distal leg soft-tissue defect were included. Forty-eight patients treated with P-NCF were compared with 44 patients treated by F-NCF. The etiology, size, and operation time were noted. The clinical outcomes and the complications have been analyzed.

Results: Age, sex, and defect etiology, duration of surgery and, area of flaps did not reveal significant differences in term of clinical outcome. Minor flap necrosis (<10%) was observed in 20.5% of the F-NCF group and 6.25% of the P-NCF group. Patient satisfaction, aesthetic appearance, and functional outcome were comparable in both groups.

Conclusion: A high rate of complications was observed in the F-NCF group. Based on our finding, a perforator-based flap is more reliable than a fascia-based flap and the two types of flaps are both valuable choices for reconstructive surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Ankle Injuries / pathology
  • Ankle Injuries / surgery
  • Female
  • Foot Injuries / pathology
  • Foot Injuries / surgery
  • Free Tissue Flaps* / blood supply
  • Free Tissue Flaps* / pathology
  • Graft Survival
  • Heel / blood supply
  • Heel / pathology
  • Heel / surgery*
  • Humans
  • Leg Injuries / pathology
  • Leg Injuries / surgery
  • Male
  • Necrosis
  • Plastic Surgery Procedures / methods*
  • Soft Tissue Injuries / pathology
  • Soft Tissue Injuries / surgery*
  • Sural Nerve / blood supply
  • Sural Nerve / surgery*
  • Surgical Flaps* / blood supply
  • Surgical Flaps* / pathology
  • Treatment Outcome