Tharayil Jose, Patil Rahul K
Department of Plastic and Reconstructive Surgery, Lakeshore Hospital, Cochin, Kerala, India.
Indian J Plast Surg. 2012 Jan;45(1):45-52. doi: 10.4103/0970-0358.96584.
Large soft tissue defects around the lower third of the leg, ankle and foot always have been challenging to reconstruct. Reverse sural flaps have been used for this problem with variable success. Free tissue transfer has revolutionised management of these problem wounds in selected cases.
Twenty-two patients with large defects around the lower third of the leg, ankle and foot underwent reconstruction with reverse peroneal artery flap (RPAF) over a period of 7 years. The mean age of these patients was 41.2 years.
Of the 22 flaps, 21 showed complete survival without even marginal necrosis. One flap failed, where atherosclerotic occlusion of peroneal artery was evident on the table. Few patients had minor donor site problems that settled with conservative management.
RPAF is a very reliable flap for the coverage of large soft tissue defects of the heel, sole and dorsum of foot. This flap adds versatility in planning and execution of this extended reverse sural flap.
小腿下三分之一、踝关节及足部周围的大面积软组织缺损一直是重建手术中的难题。逆行腓肠神经营养血管皮瓣已用于解决这一问题,但效果不一。在某些特定病例中,游离组织移植彻底改变了这些难愈伤口的治疗方式。
在7年的时间里,22例小腿下三分之一、踝关节及足部周围存在大面积缺损的患者接受了腓动脉逆行皮瓣(RPAF)修复术。这些患者的平均年龄为41.2岁。
22例皮瓣中,21例完全存活,甚至未出现边缘坏死。1例皮瓣失败,术中可见腓动脉存在动脉粥样硬化性闭塞。少数患者供区出现轻微问题,经保守治疗后得到解决。
RPAF是一种非常可靠的皮瓣,可用于覆盖足跟、足底及足背的大面积软组织缺损。该皮瓣为这种改良的逆行腓肠神经营养血管皮瓣的设计和应用增加了灵活性。