Efficacy of the Free-Style, Perforator-Plus Flaps in the Reconstruction of the Soft Tissue Defects at the Lower Leg and Ankle Regions

Abstract

ABSTRACTBackground: Reconstruction of the lower leg and ankle soft tissue defects is not that the convenient task, due to the unique anatomy and its variation. Aim of Study: Evaluation efficacy of the Free-Style, Perforator-Plus flap concepts in the reconstruction of the soft tissue defects at lower two-thirds leg, tendo-Achilles and ankle regions.Method: A Prospective (Case Series) Study, was carried on 20 consecutive patients, which performed at the Plastic and Reconstructive Surgery Unit, of General Surgery Department, of Benha University Hospitals, and Department of Plastic and Reconstructive Surgery at Nasser Institute for Research and Treatment in the period from June 2020 to June 2021. Results: 20, consecutive, exclusively males, patients, aged from 3 to 57 years old (Mean 28 ± 12 SD years), had a “Free-Style, Perforator-Plus Flap” reconstructive surgery, to cover defects presented at lower Leg two-thirds (75% of cases), Tendo-Achilles (10%) and Ankle (15%) regions. Flap complications were encountered in 4 cases (20%): 2 cases (10%) had distal congestion, the other 2 cases had distal ischemia, which one of them developed full-thickness distal loss. The final recipient outcome “Defect Coverage” was achieved in all cases (100%). Conclusion: The Free-Style, Perforator-Plus Flap is reliable with relative efficiency, versatile, and has a modest rate of failure and need for secondary surgery. It capable to reconstruct small to relatively large, complex defects (exposed bone or hardware and chronic osteomyelitis) in the distal Leg two-thirds, Tendo-Achilles, and Ankle regions.