[Successful results with the use of a new reconstruction material for soft tissue defects of the lower extremity: neurocutaneous flaps].
BACKGROUND
We evaluated the use of distally based neurocutaneous flaps in the reconstruction of soft tissue defects in the lower extremity caused by trauma or other reasons.


METHODS
Sixty-six patients (49 males, 17 females; mean age 42 years; range 16 to 75 years) underwent reconstruction of lower extremity soft tissue defects with the use of neurocutaneous flaps. The defects were in the external (n=11) and internal malleolus (n=10), Achilles tendon (n=6), heel (n=11), foot (n=7), distal (n=9) and middle (n=7) third of the anterior tibia, the mid-plantar region (n=3), and the popliteal region (n=2). Sural and saphenous neurocutaneous flaps were used in 34 and 32 patients, respectively. The mean flap area was 135 square centimetres (range 54 to 286). The mean follow-up period was 32 months (range 11 to 58 months).


RESULTS
Of sixty-six patients treated with neurocutaneous flaps, complete survival was achieved in 57 flaps (86.4%). Partial necrosis was encountered in six patients (9%). Total flap loss occurred in three patients (4.6%) who had diabetes, hypertension, and electrical burns, respectively. The most common complication during the postoperative period was venous congestion seen in 14 patients (21%), the majority of whom had diabetes (n=5), hypertension (n=3), and electrical burns (n=3), predisposing them to microcirculation disorders. This complication was successfully managed by leech therapy in 78.6%.


CONCLUSIONS
Neurocutaneous flaps offer maximum reconstruction capacity with minimum donor site morbidity, making them a successful alternative in the treatment of soft tissue defects of the lower extremity in recent years.
Gideroğlu
Kaan
K
Department of Plastic and Reconstructive Surgery, Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey. kaangideroglu@hotmail.com
Yildirim
Serkan
S
Akan
Mithat
M
Cakir
Bariş
B
Aköz
Tayfun
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult