Reconstruction of a below-knee amputation stump using a sensate neurovascular foot skin flap: a case report

Necrotizing fasciitis of the lower extremities is a severe, life-threatening condition, and limb loss or death may occur without prompt and aggressive surgical treatment. Reconstruction is often required after adequate surgical debridement, and patients are frequently referred to reconstructive surgeons for this purpose. Herein, we present the case of a patient with extensive soft-tissue defects of the lower extremity caused by necrotizing fasciitis. The skin necrosis extended into the soft tissues just below the knee; however, we sought to establish an operative plan that would preserve the knee joint. The preserved plantar foot skin was used to reconstruct the below-knee amputation stump. We successfully performed reconstruction with a sensate neurovascular foot skin flap after below-knee amputation, and the operative wound healed within 2 months with preserved sensation. At 6 months, the patient achieved adequate lower-extremity mobility and was able to ambulate with assistance from a lower-limb prosthesis.