Outcome of Pedicled Perforator Flaps in Reconstruction of Soft Tissue Defects in Lower   One-Third of the Leg

Objective: To assess the versatility of pedicled perforator flaps in lower one third of leg in terms of outcomes, postoperative complications and role in early rehabilitation of patients. Study Design: Observational study. Place and Duration of Study: Department of Plastic Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Dec 2019 to Dec 2020. Methodology: Thirty-seven patients meeting the exclusion and inclusion criteria for reconstruction of lower 1/3rd of leg were included. Pedicled perforator flaps based on the perforators of anterior tibial artery, posterior tibial artery or peroneal artery was harvested for wound reconstruction. Outcomes of the flaps were measured in terms of wound healing time, donor site management, its complication and return to the work of all patients. Result: Overall success of pedicled perforator flaps in lower one third of leg was seen in 33(81.1%) patients. Donor site was covered with partial thickness skin graft in 33(89.2%) patients. Complications included 4(10.8%) wound infection, 2(5.4%) partial flap necrosis and 1(2.7%) case of flap failure. Mean healing time of flap was 18.56±11.50 days and patients returned to work in 3±1.39 months. Conclusion: Pedicled perforator flaps are a technically straightforward procedure, provide localized like-for-like skin coverage of complex wound in lower 1/3rd of leg with excellent results and significantly low complication rate.