Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study

Purpose The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods This prospective clinical...

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Main Authors: Lakshmi Palukuri, Sreedharala Srinivas, Dharmapuri Madhulika, Sanujit Pawde, Ajo Sebastian, Swathi Sankar, Sandeep Reddy Chintha
Format: Article
Language:English
Published: Korean Society of Traumatology 2023-12-01
Series:Journal of Trauma and Injury
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Online Access:http://jtraumainj.org/upload/pdf/jti-2023-0042.pdf
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author Lakshmi Palukuri
Sreedharala Srinivas
Dharmapuri Madhulika
Sanujit Pawde
Ajo Sebastian
Swathi Sankar
Sandeep Reddy Chintha
author_facet Lakshmi Palukuri
Sreedharala Srinivas
Dharmapuri Madhulika
Sanujit Pawde
Ajo Sebastian
Swathi Sankar
Sandeep Reddy Chintha
author_sort Lakshmi Palukuri
collection DOAJ
description Purpose The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm2, and extensive defects as large as 16 cm × 14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm2, and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.
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spelling doaj-art-cf70bd6ec90d4457bbcb68a8ea57cf5f2025-01-16T05:40:12ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832023-12-0136436937510.20408/jti.2023.00421273Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical studyLakshmi Palukuri0Sreedharala Srinivas1Dharmapuri Madhulika2Sanujit Pawde3Ajo Sebastian4Swathi Sankar5Sandeep Reddy Chintha6 Department of Plastic Surgery, Osmania Medical College and Hospital, Hyderabad, India Department of Neurosurgery, Osmania Medical College and Hospital, Hyderabad, India Department of Plastic Surgery, Osmania Medical College and Hospital, Hyderabad, India Department of Plastic Surgery, Osmania Medical College and Hospital, Hyderabad, India Department of Plastic Surgery, Osmania Medical College and Hospital, Hyderabad, India Department of Plastic Surgery, Osmania Medical College and Hospital, Hyderabad, India Department of Plastic Surgery, Osmania Medical College and Hospital, Hyderabad, IndiaPurpose The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm2, and extensive defects as large as 16 cm × 14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm2, and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.http://jtraumainj.org/upload/pdf/jti-2023-0042.pdfsural artery flapsoft tissue defectssensate flapknee and proximal third defects
spellingShingle Lakshmi Palukuri
Sreedharala Srinivas
Dharmapuri Madhulika
Sanujit Pawde
Ajo Sebastian
Swathi Sankar
Sandeep Reddy Chintha
Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study
Journal of Trauma and Injury
sural artery flap
soft tissue defects
sensate flap
knee and proximal third defects
title Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study
title_full Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study
title_fullStr Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study
title_full_unstemmed Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study
title_short Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study
title_sort proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in india a clinical study
topic sural artery flap
soft tissue defects
sensate flap
knee and proximal third defects
url http://jtraumainj.org/upload/pdf/jti-2023-0042.pdf
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