Der Einsatz des Neuro-Fasziokutanen Suralisinsellappens zur Defektdeckung im Bereich des Unterschenkels und des Fußes

Abstract

BackgroundThe closure of soft tissue defects in areas of the distal third lower leg anterior, ankle, heel and foot dorsum especially with exposed bony or tendinous tissue, in case of infections or difficult healing tendency is still challenging. These defects need a stable and sufficient soft tissue cover.With the introduction of the Neuro-Fasciocutaneus suralis island flap (hereinafter called suralis flap) we do have a good alternative with stable results and less operation complexity. Material and methodsSince 2005 we are using this technique for the coverage of complicated defect wounds, especially for complete heel and extensive foot dorsum defects.The most frequent area was the lateral malleolus and the Achilles tendon area with and maximum dimension of 7cm by 11cm. Results2 suralis flaps get lost; in 6 cases we saw superficial skin necrosis.In most of the harvest areas we could directly close the defects, in 7 cases we had to close the defects with split skin grafts.Technically it is easy to learn the harvest of the suralis flap and none of ourpatient's complaint about the reduces sensitivity after necessitated cutting of the suralis nerve. ConclusionDefects in areas of the distal third lower leg anterior, ankle, heel and foot dorsum does need a stable and sufficient soft tissue cover, especially with exposed bony or tendinous tissue or in case of infections or difficult healing tendency.The suralis flap as an alternative to the commonly used free flaps and reduces the surgical effort.