Assi Chahine, Fawaz Wissam, Samaha Camille, Chamoun Moussa, Yammine Kaissar
J Med Liban. 2016 Jul-Sep;64(3):164-7. doi: 10.12816/0031526.
Soft tissue defects in the foot and ankle region are challenging conditions particularly in diabetic patients. We evaluated the reliability of the sural flap in treating such defects among a diabetic population.
This is a continuous retrospective series of 14 patients with type 2 diabetes treated with an ipsilateral sural flap for soft tissue defects around the rear foot (11 cases) and over the malleolar areas (3 cases). Three patients had an open tibia fracture (Gustillo IIIb), four had chronic osteitis and seven had a chronic heel ulcer.
The mean follow-up at 28 months showed healing of the flap at a mean of 24 days, donor site healing in two weeks, one case of total flap necrosis, three cases of skin edge necrosis, two cases of temporary venous congestion and 10 cases of hypoesthesia of the lateral border of the foot. No infection or recurrence of infection was encountered.
We found the sural flap useful, reproducible and reliable in treating soft tissue defects in diabetic patients with a low frequency of serious complications.
足踝部软组织缺损是具有挑战性的病症,在糖尿病患者中尤为如此。我们评估了腓肠神经营养血管皮瓣在治疗糖尿病患者此类缺损中的可靠性。
这是一项连续的回顾性系列研究,共14例2型糖尿病患者,采用同侧腓肠神经营养血管皮瓣治疗后足周围(11例)和踝部区域(3例)的软组织缺损。3例患者伴有开放性胫骨骨折(Gustillo IIIb型),4例患有慢性骨炎,7例患有慢性足跟溃疡。
平均随访28个月显示,皮瓣平均在24天愈合,供区在两周内愈合,1例皮瓣完全坏死,3例皮缘坏死,2例出现暂时性静脉淤血,10例足部外侧缘感觉减退。未发生感染或感染复发。
我们发现腓肠神经营养血管皮瓣在治疗糖尿病患者软组织缺损方面有用、可重复且可靠,严重并发症发生率低。