Proximal-based saphenous neurocutaneous flaps: a novel tool for reconstructive surgery in the proximal lower leg and knee

J Reconstr Microsurg. 2013 Jul;29(6):373-8. doi: 10.1055/s-0033-1343958. Epub 2013 Apr 23.

Abstract

Background: Soft tissue defects around the knee region are usually complex and require adequate reconstruction with flaps. In this article, we present our experience using the proximal-based saphenous neurocutaneous flap for the reconstruction of soft tissue defects around the knee and the proximal lower leg.

Methods: Between 2008 and 2010, 17 patients with soft tissue defects around the knee and the proximal lower leg were treated with proximal-based saphenous neurocutaneous flaps. The age of patients ranged from 19 to 61 years (mean 35.6 years). Defect sizes ranged from 3 cm × 4 cm to 9 cm × 18 cm and the flaps were designed with sizes ranging from 3 cm × 5 cm to 11 cm × 20 cm. The mean follow-up was 16 months (range 8 to 26 months).

Results: Sixteen flaps survived completely, and one flap developed partial necrosis. Mild swelling was observed within a few days postoperatively, and no severe venous congestion occurred. The skin grafts in the donor sites survived completely. All of the 17 flaps gained a good sensory recovery, and only 2 patients complained of numbness on the grafted donor-site during extended follow-up.

Conclusion: Our experience has demonstrated that the proximal-based saphenous neurocutaneous flap is a safe and reliable tool for reconstruction of the defects around the proximal lower leg and knee.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Graft Survival
  • Humans
  • Injury Severity Score
  • Knee Injuries / diagnosis
  • Knee Injuries / surgery
  • Leg Injuries / diagnosis
  • Leg Injuries / surgery
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Saphenous Vein / transplantation
  • Skin Transplantation / methods*
  • Soft Tissue Injuries / diagnosis
  • Soft Tissue Injuries / surgery*
  • Surgical Flaps / blood supply*
  • Surgical Flaps / innervation*
  • Treatment Outcome
  • Wound Healing / physiology
  • Young Adult