BACKGROUND: Soft-tissue defects in the lower leg, ankle, and heel often require reconstruction with local or free flaps. We try to compare the clinical outcome and complications following transfer of a perforator pedicle-based sural neurocutaneous flap (P-NCF) or a fascia pedicle-based sural neurocutaneous flap (F-NCF). METHODS: Between March 2007 and December 2010, 92 patients (mean, 36.52 years) with a distal leg soft-tissue defect were included. Forty-eight patients treated with P-NCF were compared with 44 patients treated by F-NCF. The etiology, size, and operation time were noted. The clinical outcomes and the complications have been analyzed. RESULTS: Age, sex, and defect etiology, duration of surgery and, area of flaps did not reveal significant differences in term of clinical outcome. Minor flap necrosis (<10%) was observed in 20.5% of the F-NCF group and 6.25% of the P-NCF group. Patient satisfaction, aesthetic appearance, and functional outcome were comparable in both groups. CONCLUSION: A high rate of complications was observed in the F-NCF group. Based on our finding, a perforator-based flap is more reliable than a fascia-based flap and the two types of flaps are both valuable choices for reconstructive surgery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
BACKGROUND: Soft-tissue defects in the lower leg, ankle, and heel often require reconstruction with local or free flaps. We try to compare the clinical outcome and complications following transfer of a perforator pedicle-based sural neurocutaneous flap (P-NCF) or a fascia pedicle-based sural neurocutaneous flap (F-NCF). METHODS: Between March 2007 and December 2010, 92 patients (mean, 36.52 years) with a distal leg soft-tissue defect were included. Forty-eight patients treated with P-NCF were compared with 44 patients treated by F-NCF. The etiology, size, and operation time were noted. The clinical outcomes and the complications have been analyzed. RESULTS: Age, sex, and defect etiology, duration of surgery and, area of flaps did not reveal significant differences in term of clinical outcome. Minor flap necrosis (<10%) was observed in 20.5% of the F-NCF group and 6.25% of the P-NCF group. Patient satisfaction, aesthetic appearance, and functional outcome were comparable in both groups. CONCLUSION: A high rate of complications was observed in the F-NCF group. Based on our finding, a perforator-based flap is more reliable than a fascia-based flap and the two types of flaps are both valuable choices for reconstructive surgery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.