[Flaps for soft tissue defect closure in the distal lower leg]

Area of Science:

• Reconstructive surgery
• Lower extremity trauma
• Tissue engineering

Context:

• Distal lower leg soft tissue defects present significant reconstructive challenges, particularly following trauma.
• Early defect closure is crucial for optimal patient outcomes and limb salvage.
• Traditional methods may involve complex microvascular free flaps.

Purpose:

• To evaluate the efficacy of pediculated adipofascial suralis and soleus muscle flaps for distal lower leg defect reconstruction.
• To compare these flap options with microvascular free flaps.
• To highlight the advantages of local flaps in specific clinical scenarios.

Summary:

• The pediculated adipofascial suralis flap offers a reliable blood supply and broad coverage for most distal lower leg defects (up to 10x10 cm), with well-tolerated donor sites.
• The soleus muscle flap is suitable for defects in the middle and proximal distal thirds of the lower leg, though occasional calf function reduction may occur.
• Both flaps demonstrate advantages, making them effective alternatives to microvascular free flaps for reconstructing distal lower leg soft tissue defects.

Impact:

• Provides valuable insights for surgeons managing lower extremity trauma and soft tissue defects.
• Offers less invasive and potentially more accessible reconstructive options.
• Contributes to improved functional and aesthetic outcomes in lower leg reconstruction.