[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.
Department of Plastic and Reconstructive Surgery, Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey. kaangideroglu@hotmail.com
Kaan
K
Gideroğlu
Serkan
S
Yildirim
Mithat
M
Akan
Bariş
B
Cakir
Tayfun
T
Aköz
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