Abstract
BackgroundReconstructions the soft-tissue defects of the distal lower extremities in the elderly patients (≥ 60 years old) are full of challenges because of many comorbidities. The purpose of this study was to report the clinical application of the distally based sural flap in the elderly patients, and to verify the reliability of this flap in the elderly patients.MethodsBetween March of 2005 and December of 2019, 53 patients aged over 60-year-old and 55 patients aged 18 to 30-year-old who underwent the procedure have been included in this study. The reconstruction outcomes, medical-related complications, flap viability-related complications and potential risk factors are compared between the group A (≥ 60 years old) and group B (ranging from 18 to 30 years old).ResultsThe partial necrosis rate in group A (9.43%) is higher than group B (9.09%), but the difference is not significant (P > 0.05). The constitute ratio of the defects that were successfully covered using the sural flap alone or combining with simple salvage method (i.e., skin grafting) is 96.22% and 98.18% in group A and B, respectively (P > 0.05). The differences of the risk flaps factors that affected the survival of distally based sural flap were not significant between group A and B (P > 0.05).ConclusionsThe distally based sural flap can be effectively used to repair the soft-tissue defect of the lower extremity in the elderly patients. It is safe and reliable to harvest and transfer the flap in one stage, and the delay surgery is not necessary.
Highlights
Reconstructions the soft-tissue defects of the distal lower extremities in the elderly patients (≥ 60 years old) are full of challenges because of many comorbidities
The soft-tissue defects of the distal lower extremities are common in the elderly patients, and the reconstructions of these defects are full of challenges because of many comorbidities
Many studies have shown that the advanced age (> 60 years old) is an independent risk factor affected the partial necrosis of the distally based sural flap, and the survival of the flap is threatened by long-term adverse lifestyle and medical comorbidities in the elderly patients [14,15,16]
Summary
Reconstructions the soft-tissue defects of the distal lower extremities in the elderly patients (≥ 60 years old) are full of challenges because of many comorbidities. Many studies have shown that the advanced age (> 60 years old) is an independent risk factor affected the partial necrosis of the distally based sural flap, and the survival of the flap is threatened by long-term adverse lifestyle (i.e., abuse of cigarette and alcohol) and medical comorbidities (i.e., hypertension, diabetes, atherosclerosis, and so on) in the elderly patients [14,15,16]. The questions of both whether the distally based sural flap can be applied in the elderly patients safely and reliably, and how to improve the flap viability in the elderly patients have not been elucidated in the publications. The purpose of this study was to report the clinical application of the distally based sural flap in the elderly patients, and to verify the reliability of this flap in the elderly patients by comparing with the young patients aged 18–30 years who have the best physical condition without any comorbidity during the same period
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