Summary
Defects involving the distal leg and foot are frequently encountered following various
aetiological factors. Paucity of local tissue causes surgeons to resort to the retrograde
peninsular flap, the cross leg flap or the free flap. With specific knowledge of perforators,
the fasciocutaneous flap from the calf area can be transferred to the defect in a
single stage based on skeletonised distal perforators. The surgical anatomy, flap
planning and procedure have been detailed. Nineteen patients were treated during the
period 1995 to 2005. The perforators were identified preoperatively by audio Doppler.
The flaps were marked and dissected proximal to the defect skeletonising the distal
perforators under loupe magnification and transferred to the defect in a single stage.
The donor site was skin grafted. Out of 19 cases, 16 flaps healed uneventfully, one
flap necrosed completely and in two cases there was marginal necrosis. The cases were
followed up for 2–10 years with an average of 6 years. With detailed knowledge of
perforators one can safely reconstruct distal moderate-size defects of the lower limb
in a single stage, thus having the benefits of free tissue transfer without resorting
to microsurgery. This technique has proved to be an advancement in the reconstructive
repertoire allowing flaps of non conventional dimensions to be perfused by skeletonised
perforators.
Keywords
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Article info
Publication history
Published online: April 02, 2007
Accepted:
February 18,
2007
Received:
July 7,
2006
Footnotes
☆Financial disclosure and products page: There are no financial or product considerations for any author of this article.
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
