Free Proximal Lateral Leg Flap

Abstract

Soft tissue reconstruction with free perforator flap is popular in recent years. However, it is still a challenge to repair a small and thin defect with a free flap. A suitable flap must be thin, pliable, and easy to harvest and reconstruct. The proximal lateral leg flap from lateral lower leg is one of the ideal flap for reconstructing such defects. The authors applied free proximal lateral leg flaps to 7 patients with soft-tissue defects from March 2005 to November 2005. The recipient site was the heel in one case, the lateral foot in one case, the dorsal foot in one case, the posterior ankle in two cases, and head and neck in two cases. The largest flap was 11 x 5 cm and the smallest flap was 5 x 2.5 cm in size. The average thickness of this flap is 5.9 mm. Vascular pedicle lengths ranged from 5 to 8 cm. The average diameter of flap artery was 1.2 mm. All flaps survived completely. No major complications were encountered. All the donor wounds were closed primarily without difficulties. The proximal lateral leg flap has many advantages: (1) no need to sacrifice any main arteries in the lower leg; (2) minimal morbidity at the donor site; (3) short time to harvest the flap; (4) thin and flexible flap; and (5) primary closure at the donor site in most cases. We conclude that this free perforator flaps is useful for patients with a small to medium soft-tissue defect.