Utilisation of distally based sural fasciocutaneous flaps in lower extremity reconstruction: a single-centre experience with 88 paediatric patients

Zhaobiao Luo,Ping Peng,Zhonggen Dong,Lihong Liu,Guohua Lv,Jiangdong Ni,Jianwei Wei

doi:10.1186/s13018-021-02206-x

Abstract

BackgroundNo large series have analysed distally based sural fasciocutaneous (DBSF) flaps in paediatric patients. The aims of this study were to assess the reliability and analyse the potential risk factors for these flaps and to describe complications in the donor site and the functional follow-up results.MethodsBetween June 2002 and November 2017, 88 DBSF flaps were used to reconstruct soft tissue defects in paediatric patients. Potential risk factors, reconstruction outcomes, and complications in the donor site of the flaps were analysed.ResultsAmong the 88 flaps, partial necrosis developed in 8 flaps (9.1%). The partial necrosis rate was significantly higher in flaps with the top edge located in the 9th zone (26.1%), with a length-width ratio (LWR) ≥ 5:1 (28.6%), and with a dimension of the skin island ≥ 100 cm2 (22.7%). Partial necrosis did not occur in flaps with a dimension of the skin island < 80.0 cm2 or with a skin-island width < 7.0 cm. The reconstruction outcomes in most paediatric patients were evaluated as “excellent” or “good”. The incidence of obvious scarring was higher in the donor site.ConclusionsPartial necrosis of DBSF flaps will significantly increase when the top edge of the flap is located in the 9th zone, when the LWR of the flap is ≥ 5:1, or when the dimension of the skin island is ≥ 100.0 cm2. Flaps with a skin-island width < 7.0 cm or with a dimension of the skin island < 80 cm2 are relatively safe and reliable.

Highlights

Reconstruction of soft tissue defects in the distal leg, ankle, and foot is always a delicate problem, especially for paediatric patients
As introduced in the previous article [35], we considered that length-width ratio (LWR) ≥ 5:1 is a risk factor for distally based sural fasciocutaneous (DBSF) flap in the paediatric patients
The results suggested that the flap could help repair relatively larger defects, the DBSF flap with a dimension of the skin island < 80.0 cm2 was safer and more reliable, and the possibility of partial necrosis increased significantly if the dimension of the skin island was ≥ 100.0 cm2

Summary

Introduction

Reconstruction of soft tissue defects in the distal leg, ankle, and foot is always a delicate problem, especially for paediatric patients. A specific focus on analysing potential risk factors for DBSF flaps with a considerable sample size for the reconstruction of these defects in paediatric patients is lacking. The aims of this study are to assess reliability and analyse the potential risk factors for DBSF flaps in paediatric patients with a considerable sample size and to describe complications in the donor site and functional follow-up results. The aims of this study were to assess the reliability and analyse the potential risk factors for these flaps and to describe complications in the donor site and the functional follow-up results

Objectives

Methods

Results

Conclusion