Sural perforator flap for reconstructive surgery in the lower leg and the foot: a clinical study of 86 patients with post-traumatic osteomyelitis.

Abstract

BACKGROUND:

The treatment of post-traumatic osteomyelitis of the lower leg and the foot remains a challenge in reconstructive surgery.

MATERIAL AND METHODS:

Eighty-six patients with lower leg post-injury chronic osteomyelitis were included in a retrospective, non-controlled clinical study conducted from 1995 to 2006. All study patients were managed by distally based sural neuro-fascio-cutaneous perforator flap. An endpoint survey was conducted after flap surgery and had a mean follow-up period of 5.5 years, wherein the response rate was 48%.

RESULTS:

Seven patients had a short-term flap failure (8%; 95% CI 3-16%). An additional eight patients (7%) had flap necrosis of less than one-fourth of the flap that healed without surgical revision. Based on the endpoint data, the long-term success rate was 87% (95%, CI 72-96%). Local and/or systemic physiological compromise was a risk factor for flap failure. Other assumed risk factors had no statistically significant impact on short- or long-term results.

CONCLUSION:

Sural perforator flap is a robust flap with low failure rate, even in high-risk patients. The success rate compares favourably with results of free flap transfers in the management of post-traumatic osteomyelitis. The flap has a wide range, and the surgical technique is rather simple. The sural flap is a feasible option for post-traumatic reconstructions of osteomyelitis, especially in low-resource settings.

• Authors: N Tajsiç, R Winkel, R Hoffmann, H Husum
• Journal: Journal of plastic, reconstructive & aesthetic surgery : JPRAS (J Plast Reconstr Aesthet Surg) Vol. 62 Issue 12 Pg. 1701-8 (Dec 2009) ISSN: 1878-0539 [Electronic] Netherlands
• PMID: 19071078 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Chronic Disease
• Epidemiologic Methods
• Female
• Foot (surgery)
• Humans
• Leg (surgery)
• Leg Injuries (complications)
• Male
• Middle Aged
• Osteomyelitis (etiology, pathology, surgery)
• Plastic Surgery Procedures (methods)
• Surgical Flaps
• Treatment Failure