Treatment of Skin and Soft Tissue Defect in the Distal Leg, Ankle and Foot with Flaps

Abstract

Compared with other regions, open wounds around the ankle are difficult to treat, especially in patients with exposed bone, as there is less soft tissue, which delays healing. In addition, the choice of flap around the ankle is limited, which means that a free flap is often needed. A retrospective review of 11 patients who underwent reconstruction around the ankle at our institution after 1996 was performed. In these patients, causes and sites of defects, types of flap, survival rate, and complications were evaluated. Three pedicle flaps and eight free flaps were performed. The pedicle flaps included two distally based superficial sural artery flaps and one peroneal perforator flap. The free flaps included two anterolateral thigh flaps, two tensor fascia lata flaps, one latissimus dorsi muscle flap, two peroneal perforator flaps, and one saphenous flap. There were 3 cases of complications : one partial flap necrosis and two with bulkiness of the flap. Because it was difficult to accommodate the pedicle flap to a wide range of defects around the ankle, many free flaps were selected. After evaluating the lost tissue that needs to be reconstructed, the appropriate flap should be selected.