Shin In Soo, Lee Dong Won, Rah Dong Kyun, Lee Won Jai
Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Arch Plast Surg. 2012 Jul;39(4):360-6. doi: 10.5999/aps.2012.39.4.360. Epub 2012 Jul 13.
Coverage of defects of the pretibial area remains a challenge for surgeons. The difficulty comes from the limited mobility and availability of the overlying skin and soft tissue. We applied variable pedicled perforator flaps to overcome the disadvantages of local flaps and free flaps on the pretibial area.
Eight patients who had the defects in the anterior tibial area were enrolled. Retrospective data were obtained on patient demographics, cause, defect location, defect size, flap dimension, originating artery, pedicle length, pedicle rotation, complication, and postoperative result. The raw surface created following the flap elevation was covered with a split thickness skin graft.
Posterior tibial artery-based perforator flaps were used in five cases and peroneal artery-based perforator flaps in three cases. The mean age was 54.3 and the mean period of follow-up was 6 months. The average size of the flaps was 63.8 cm(2), with a range of 18 to 135 cm(2). There were no major complications. No patients had any newly developed functional deficit of the lower leg.
We suggest that pedicled perforator flaps can be an alternative treatment modality for covering pretibial defects as a simple, safe and versatile procedure.
胫骨前区缺损的覆盖对外科医生来说仍是一项挑战。困难源于覆盖其上的皮肤和软组织的活动度及可用性有限。我们应用带蒂穿支皮瓣来克服局部皮瓣和游离皮瓣在胫骨前区的缺点。
纳入8例胫骨前区有缺损的患者。获取了关于患者人口统计学、病因、缺损部位、缺损大小、皮瓣尺寸、供血动脉、蒂长度、蒂旋转、并发症及术后结果的回顾性数据。皮瓣掀起后形成的创面用中厚皮片覆盖。
5例采用了以胫后动脉为蒂的穿支皮瓣，3例采用了以腓动脉为蒂的穿支皮瓣。平均年龄为54.3岁，平均随访时间为6个月。皮瓣平均大小为63.8平方厘米，范围为18至135平方厘米。无重大并发症。无患者出现小腿新的功能障碍。
我们认为，带蒂穿支皮瓣作为一种简单、安全且通用的手术方法，可作为覆盖胫骨前区缺损的一种替代治疗方式。
