[Repair of tissue defect of lower leg and foot with reverse island skin flaps with sural nerve and blood supplying vessels].
OBJECTIVE
To observe the clinical effect of reverse island skin flaps with sural nerve and blood supplying vessels on repair of tissue defect of lower leg and foot.


METHODS
Fifty-six patients with lower leg and foot tissue defects were hospitalized from June 1997 to August 2007. Among them, 10 patients suffered from soft tissue defect of lower leg; 38 patients suffered from wound infection, exposure of fracture of tibia and fibula, and osteonecrosis; 8 patients suffered from heelstick tissue defect, bone adhering scar, and osteomyelitis. The defects were repaired with sural nerve and blood vessel nourished reverse island skin flaps (46 cases) and myocutaneous flaps (10 cases). The size of flaps ranged from 5 cm x 4 cm to 22 cm x 16 cm. Flap donor sites were closed by direct suture or free skin grafting.


RESULTS
Flaps in 55 cases survived. Patients were followed up 3-6 months, there was no complication, and they were healed with satisfactory texture and appearance. The patients could walk normally, but with unsatisfactory sensory recovery. In one patient, the flap was broken and ulcerated 1 month after operation on account of leaving behind necrotic tibia. It was healed after second operation.


CONCLUSIONS
Sural nerve and blood vessel nourished reverse island skin flap or myocutaneous flap transplantation is an effective treatment for repair of soft tissue defect of lower leg and foot.
Hu
Xiao-hua
XH
Department of Burns, Jishuitan Hospital, Beijing 100035, China.
Shen
Yu-ming
YM
Wang
Zhi-yong
ZY
Chen
Zhong
Z
Li
Ming
M
Qin
Feng-jun
FJ
Zhang
Guo-an
GA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D018409:Foot Injuries / Q000601:surgery; D006801:Humans; D007869:Leg Injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013497:Sural Nerve / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation; D055815:Young Adult