Reconstruction of Regions Below the Knee Using Island Flaps.

Choi, Dong Il; Chung, Chul Hoon; Lee, Jong Wook; Kim, Jin Wang

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(3):295-302.
Published online May 1, 2008.

Reconstruction of Regions Below the Knee Using Island Flaps.

Dong Il Choi, Chul Hoon Chung, Jong Wook Lee, Jin Wang Kim

Department of Plastic and Reconstructive Surgery, College of Medicine, Hallym University, Korea. c21ps@hanmail.net

Abstract

PURPOSE
The lower leg often has poor vascularity, proximity to bone, and insufficient soft tissue. The island flaps offer a feasible one stage reconstruction and has a remarkable vascularization and high quality results for soft tissue defect with or without bony problems to occur on regions below the knee. So we reported our experience of island flaps with review of the literatures. METHODS: We reconstructed 29 cases of soft tissue and 2 cases of bony defect on regions below the knee by using various island flaps at our hospital from December, 1991 to January, 2006. We used 2 fibular osteocutaneous island flaps, 15 reverse sural island flaps, 6 extensor digitorum brevis muscular island flaps, 2 medial plantar island flaps, 5 saphenous island flaps, and a dorsalis pedis island flap.
RESULTS
Partial necrosis was developed in 4 out of 15 reverse sural island flaps and 1 out of 5 saphenous island flaps, but they were healed with secondary skin graft. There was partial loss of skin graft on the donor sites in 2 cases.
CONCLUSION
Island flaps are very useful for reconstruction of regions below the knee because island flaps have good vascularity and less risk of infection. Generous flap size, easy operative technique, lower cost, shorter operative time, and minimal morbidity at the donor site are other advantages. We attained satisfactory results.

Keywords: Island flaps; Lower leg reconstruction