title: Distally based saphenous neurocutaneous perforator flap for reconstructive surgery in the lower leg and the foot: a long-term follow-up study of 70 patients.
abstract: BACKGROUND
  The management of soft-tissue defects in the distal third of the lower leg and foot remains disputed. In this article, we describe a long-term follow-up research study on the clinical results and complications of using this flap for the reconstruction of soft-tissue defects around the lower leg and foot.
  
  
  METHODS
  Between 2006 and 2008, 70 patients with soft-tissue defects around the lower leg and foot were treated with distally based saphenous neurocutaneous perforator flaps. The mean age of patients was 46.0 years (range, 22 to 70 years). An end point survey was performed after flap coverage; the mean follow-up was 54.2 months (range, 40 to 68 months), and response rate was 92.9% (65/70). A sensory morbidity was measured with a static two-point discrimination test and Semmes-Weinstein monofilament test.
  
  
  RESULTS
  A total of 58 flaps survived completely, 6 flaps developed partial necrosis, and 1 experienced total failure. No severe venous congestion was observed and the skin grafts in the donor sites survived entirely. Sensitivity tests have shown an acceptable sensory recovery at the skin-grafted donor site and on the flap.
  
  
  CONCLUSIONS
  Distally based saphenous neurocutaneous flap is a reliable and safe method for reconstruction of the defects around the lower leg and foot, with a lower sensorial morbidity.
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, JiaoTong University, Shanghai, China.
authors.forename: Jiezhi
authors.initials: J
authors.lastname: Dai
authors.forename: Yimin
authors.initials: Y
authors.lastname: Chai
authors.forename: Chunyang
authors.initials: C
authors.lastname: Wang
authors.forename: Gen
authors.initials: G
authors.lastname: Wen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000503:physiopathology / Q000601:surgery*; D006084:Graft Rejection / Q000175:diagnosis; D006085:Graft Survival; D006801:Humans; D007869:Leg Injuries / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012501:Saphenous Vein / Q000637:transplantation*; D012677:Sensation; D017695:Soft Tissue Injuries / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome