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Proximal-based saphenous neurocutaneous flaps: a novel tool for reconstructive surgery in the proximal lower leg and
Jiezhi Dai1, Yimin Chai, Chunyang Wang
1Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, JiaoTong University, Shanghai, China.
Background:
Soft tissue defects around the knee region are usually complex and require adequate reconstruction with flaps. In this article, we present our experience using the proximal-based saphenous neurocutaneous flap for the reconstruction of soft tissue defects around the knee and the proximal lower leg.
Methods:
Between 2008 and 2010, 17 patients with soft tissue defects around the knee and the proximal lower leg were treated with proximal-based saphenous neurocutaneous flaps. The age of patients ranged from 19 to 61 years (mean 35.6 years). Defect sizes ranged from 3 cm × 4 cm to 9 cm × 18 cm and the flaps were designed with sizes ranging from 3 cm × 5 cm to 11 cm × 20 cm. The mean follow-up was 16 months (range 8 to 26 months).
Results:
Sixteen flaps survived completely, and one flap developed partial necrosis. Mild swelling was observed within a few days postoperatively, and no severe venous congestion occurred. The skin grafts in the donor sites survived completely. All of the 17 flaps gained a good sensory recovery, and only 2 patients complained of numbness on the grafted donor-site during extended follow-up.
Conclusion:
Our experience has demonstrated that the proximal-based saphenous neurocutaneous flap is a safe and reliable tool for reconstruction of the defects around the proximal lower leg and knee.