Mitigating complications in peroneal nerve trophic flaps through superficial venous connections: a case-control study.

Background: Peroneal nerve trophic flaps are essential in reconstructive surgery for lower limb defects, yet they are prone to complications such as flap necrosis and venous congestion. These issues are often linked to inadequate venous drainage. This study evaluates an innovative venous anastomosis technique to enhance flap survival and reduce complications. Materials and methods: A case-control study was conducted with 70 patients undergoing peroneal nerve trophic flap reconstruction. Patients were divided into an anastomosis group (n = 35), where the small saphenous vein was connected to the dorsal superficial foot vein ne work, and a control group (n = 35) without venous anastomosis. Complications, flap survival rates, cost-effectiveness analysis and functional outcomes were assessed over a 6-12 month follow-up period using standardized metrics and statistical analysis. Results: The anastomosis group exhibited a significantly lower complication rate (P < 0.05), with reduced incidences of flap necrosis and venous congestion compared to the control group. The cost-effectiveness analysis showed that the average total cost per case was lower in the anastomosis group (¥12 000 ± 565). Flap survival rates and functional outcomes, including sensory recovery and patient-reported satisfaction, were also not affected in the anastomosis group. Conclusion: Superficial venous anastomosis is a promising flap surgical technique that reduces complications and improves cost-effectiveness, without increasing long-term complications that affect flap function and long-term survival.