Lower leg reconstruction using distally based saphenous island flap

Abstract.

Fourteen patients with a soft tissue defect of the lower leg are presented. The cause of the defect was trauma in eight cases; unstable scar in two and the remaining cases had chronic osteomyelitis, pathological fracture, chronic non-healing ulcer, and diabetic foot. Each defect was covered by a distally based saphenous neurocutaneous island flap. Clinically, the flaps ranged in size from 4×5 cm to 18×8 cm. Nine flaps survived completely, two had marginal necrosis, another two had partial necrosis while one flap was lost completely. However, the fascia in failed flaps survived, allowing subsequent grafting. The distally based saphenous neurocutaneous island flap is a simple, versatile, one-stage procedure with a good arc of rotation and it does not require sacrifice of a major artery.