Abstract
Aim
Soft tissue defects of the lower leg can be closed - following the reconstructive ladder - with a pediculated fasciocutaneous suralis flap, but a free flap is gold standard in most of the cases. Aim of the study was to evaluate complications, risk factors for failure and the reasonableness of this procedure.
Method
91 patients (92 flaps, 70 males, 21 females) with a mean Age of 55 years (16 to 87) were included in the study. The patients had mean four surgical procedures before the flap, the follow-up was mean 407 days. 70 patients were classified ASA I or ASA II.
Results
There were many complications, mostly wound healing Problems or hematoma. Only 40% of the patients received no Revision surgery, 71% of the flaps reached healing with Maximum two revisions (22% with one, 9% with two revisions, respectively). Necrectomy and new meshgraft were main reasons for Revision. Long term complications were swelling or disturbance of sensitivity. We lost seven flaps, eight free flaps were necessary. Three amputations were performed, but only one because of the lost flap.
Conclusions
All patients with lost flaps showed relevant comorbidities. 71% of the flaps healed with Maximum two revisions and the overall flap loss rate was 6%. The Advantages of this flap are short surgery time without the need of a microvascular anastomosis and a relatively simple surgical technique. The flap loss rate of 6% seems to be acceptable and, however, the flap is a good Option and an important step of the reconstructive ladder for soft tissue defect closure of the lower leg.
