[Improvement of surgical techniques in fasciocutaneous flap of limbs].

OBJECTIVE: To summarize the effectiveness of the improved surgical techniques in fasciocutaneous flaps of the limbs.

METHODS: From February 1999 to December 2005, 58 patients (39 males, 19 females, aged 10-68 years) underwent repairs of the skin defects with improved fasciaocutaneous flaps of the limbs. Twenty-one patients had the skin defects in front of the tibial bone in the middle and lower parts, 12 patients had the skin defects in the heels, 16 patients had the skin defects in the ankles, 3 patients had the skin defects around the knees, 1 patient had a wide sacrococcygeal bedsore, and 5 patients had the skin defects in the wrists and hands. The wounds ranged in size from 5 cm x 3 cm to 18 cm x 12 cm. According to the wound locations, the following flaps were selected: 4 cutaneous antebrachii medialis nerve and basilic vein fasciocutaneous flaps, 1 cutaneous antebrachii lateralis nerve and cephalic vein fasciocutaneous flap, 3 saphenous nerve and great saphenous vein fasciocutaneous flaps, 1 cutaneous nerve of thigh posterior fasciocutaneous flap, 32 reverse sural nerve and saphenous vein fasciocutaneous flaps, and 17 reverse saphenous nerve and great saphenous vein fasciocutaneous flaps. The dissected flaps ranged in size from 6 cm x 4 cm to 18 cm x 13 cm. The donor wounds underwent straight sutures in 39 patients, and the skin-grafting (6 cm x 3 cm to 13 cmX 6 cm) was performed on 19 patients after the donor wounds were closed.

RESULTS: The wounds healed by first intention, and the flaps survived completely in 54 patients. The flaps developed partial necrosis in 4 patients. The follow-up for 1-20 months (average, 8 months) revealed that the flaps had a satisfactory appearance with a soft texture and the function was also satisfactory.

CONCLUSION: A fasciocutaneous flap of the limbs is an ideal flap for repairing defects in the skins and soft tissues of the limbs. The survival rate of the flap can be further improved by an improvement of the surgical techniques.