Clinical application of posterior tibial artery perforator flap within saphenous nerve branch for sensory reconstruction

Objective To explore the operative technique and clinical results of posterior tibial artery perforator flap within saphenous nerve branch for sensory reconstruction. Methods From January, 2016 to June, 2018, 9 patients suffered from soft tissue defect were treated by the posterior tibial artery perforator flap containing saphenous nerve branch. Seven patients were males and 2 were females, with age ranged from 31 to 62 years. Soft tissue defects located in hands in 5 patients, plantar in 2 patients, ankle in 1 patient and dorsal foot in 1 patient. The size of soft tissue defects ranged from 8.0 cm×2.5 cm to 21.0 cm×4.0 cm. The regular post-operative followed-up was performed. Results All flaps survived without complications. The size of flap ranged from 10.0 cm×3.5 cm-23.0 cm×5.0 cm. Donor sites were primarily closed in 5 patients and secondary closed in 4 patients. Followed-up ranged from 6 to 15 months with 10 months in average. The contour of flaps were satisfied and the sensory function of the donor sites were normal. At 6 months followed-up, SW test reached 5.07 in all flaps, and 2PD ranged from 14 to 35 mm. Conclusion The novel sensory flap can provide satisfied sensory outcome without sacrificing main artery and saphenous nerve, and is a good candidate for sensory reconstruction of soft tissue defects. Key words: Posterior tibial artery; Perforator flap; Saphenous nerve; Sensory reconstruction; Soft tissue defect