Ignatiadis Ioannis A, Georgakopoulos Georgios D, Tsiampa Vassiliki A, Polyzois Vasilios D, Arapoglou Dimitrios K, Papalois Apostolos E
Hand Surgery-Upper Limb and Microsurgery Department, KAT General Hospital, Athens, Greece.
Diabet Foot Ankle. 2011;2. doi: 10.3402/dfa.v2i0.7483. Epub 2011 Aug 12.
Management of Achilles tendon and heel area defects is a common challenge for the reconstructive surgeon due to the lack of soft tissue availability in that region. In this article, we present our experience in covering these defects by using the distal perforator propeller flaps based on the posterior tibial artery. Perforator flaps are based on cutaneous, small diameter vessels that originate from a main pedicle and perforate the fascia or muscle to reach the skin. Their development has followed the understanding of the blood supply from a source artery to the skin. Six patients (five males and one female) underwent reconstruction by using the posterior tibial artery distal perforator flap for covering defects in the distal Achilles tendon region in patients with and without diabetes mellitus. Postoperative complications included a hypertrophic scar formation in one patient, partial marginal flap necrosis in another patient, and a wound infection in a third patient. All wounds were eventually healed by the last postoperative visit. In conclusion, perforator flaps based on the distal posterior tibial artery may be a reliable option for the coverage of small to moderate size defects of the Achilles tendon and heel area regions.
由于跟腱和足跟区域缺乏可用的软组织，对于重建外科医生来说，处理该区域的缺损是一项常见的挑战。在本文中，我们介绍了使用基于胫后动脉的远端穿支推进皮瓣覆盖这些缺损的经验。穿支皮瓣基于起源于主蒂的皮肤小直径血管，这些血管穿过筋膜或肌肉到达皮肤。它们的发展是基于对从源动脉到皮肤的血液供应的理解。六名患者（五名男性和一名女性）接受了使用胫后动脉远端穿支皮瓣的重建手术，以覆盖患有和未患有糖尿病的患者跟腱远端区域的缺损。术后并发症包括一名患者形成肥厚性瘢痕，另一名患者皮瓣部分边缘坏死，第三名患者伤口感染。所有伤口在最后一次术后随访时最终愈合。总之，基于胫后动脉远端的穿支皮瓣可能是覆盖跟腱和足跟区域中小尺寸缺损的可靠选择。
