title: [The soleus muscle flap].
abstract: OBJECTIVE
  Defect coverage especially in exposed bone of the lower leg by pedicled muscle flaps in association with a split-thickness skin graft. Defect coverage oropharyngeal or at the upper extremity by free soleus flaps.
  
  
  METHODS
  Defects of the proximal and middle thirds of the anterior lower leg for the proximally pedicled soleus flap; defects of the middle and distal third of the anterior lower leg for the distally pedicled soleus flap. The free flap is almost ubiquitously useable.
  
  
  METHODS
  Primary diseases that makes a 2-h operation impossible, relevant affection of supplying vessels (the posterior tibial artery and/or the peroneal artery). Inadequate perfusion of the lower leg due to angiopathy, extensive soft-tissue infection, and wound contamination.
  
  
  METHODS
  Medial, longitudinal incision, slightly posterior to the tibia, according to the desired flap elevation (distally or proximally pedicled). Preparation of relevant vessels, mobilization of the muscle and transposition into local defects or use as a free graft. The pedicled flaps usually need a split-thickness skin graft to cover.
  
  
  METHODS
  Close monitoring of blood flow, temperature and swelling situation (hourly). Pressure-free wound-dressing of the leg, no circular or constricting dressings. Bedrest for 10 days, then start of flap training with intermittent circular compression, thrombosis prophylaxis, nicotine abstinence, physiotherapy, which depends on the bony situation, compression stocking after 3 weeks.
  
  
  RESULTS
  Reliable results achieved at the middle and distal lower leg.
authors.affiliation: Klinik für Plastische, Ästhetische und Handchirurgie, Klinikum Lippe GmbH, Rintelner Str. 85, 32657, Lemgo, Deutschland. Janos.hankiss@klinikum-lippe.de
authors.forename: J
authors.initials: J
authors.lastname: Hankiss
authors.forename: C
authors.initials: C
authors.lastname: Schmitz
mesh_terms: D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000637:transplantation*; D016896:Treatment Outcome