OBJECTIVETo investigate the indications and effects of different levels of perforator-based sural neurofasciocutaneous flaps in repairing lower limb defects.

METHODSFrom 2004 to 2012,13 cases of soft tissue defects of lower extremity were successfully reconstructed using different levels of perforator-based sural neurofasciocutaneous flaps, included 8 males and 5 females with an average age of 38.6 years old ranging from 15 to 76 years old. Perforator-based sural neurofasciocutaneous flaps located at 4 to 7 cm above the tip of the lateral malleolus were used to resurface ankle and foot defects in 8 cases, perforator-based sural neurofasciocutaneous flaps located on 9 to 11 cm above the tip of the lateral malleolus were used to resurface lower third leg defects in 3 cases, as well as perforator-based sural neurofasciocutaneous flaps located on 2 cm above the tip of the lateral malleolus were used to repair heel defects in 2 cases. The area of the transferred flaps ranged from 4.5 cm x 2.5 cm to 16 cm x 10 cm. The donor sites were covered with skin grafts.

RESULTSAll the flaps survived uneventfully with primary healing. Eight patients were follow-up for 1 to 12 months with an average of 6 months. The color, luster and texture of flap were good, thickness of flaps was fair. No empyrosis and ulcer occurred. The contour and function were satisfied with both the donor and recipient site.

CONCLUSIONSatisfactory functional results can be achieved by using different segment of perforator-based sural neurofasciocutaneous flaps for repairing lower extremity defects.