Singh Kuldeep, Rohilla Rajesh, Singh Raj, Singh Sarita, Singh Bikramjit, Tanwar Milind
Department of Burn and Plastic Surgery, Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India.
Department of Orthopaedics, Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India.
J Ayub Med Coll Abbottabad. 2017 Jul-Sep;29(3):462-465.
Due to precarious blood supply, skin coverage for defects of leg, heel, dorsum of foot and the ankle has been a complicated task for plastic surgeons & orthopaedic surgeons. The present study aimed to prospectively evaluate the outcome of distally based sural flap for coverage of defects distal third of leg, ankle & foot.
In this study 15 patients with soft tissue defects on distal third of leg in (n=2), heel (n=4), medial malleolus (n=3), lateral malleolus (n=1), Achillis tendon (n=2), anterior ankle (n=2) and in dorsum of foot (n=1) were operated for coverage of defect by distally based sural flap. All the cases were done as secondary procedures.
All the flaps showed good results except five minor complications. Three flaps showed superficial skin necrosis and two showed partial tip necrosis.
Distally based sural artery flap is very useful in covering the defects of lower leg, heel and dorsum of foot. It is reliable, easy to raise with minimal morbidity to the patient. This flap does not sacrifice any of the major vessels of the limb and hence it is very safe flap.
由于血供不稳定，对于整形外科医生和骨科医生而言，为小腿、足跟、足背和脚踝的缺损进行皮肤覆盖一直是一项复杂的任务。本研究旨在前瞻性评估以远端为蒂的腓肠神经营营皮瓣覆盖小腿远端三分之一、脚踝和足部缺损的效果。
在本研究中，对15例小腿远端三分之一（n = 2）、足跟（n = 4）、内踝（n = 3）、外踝（n = 1）、跟腱（n = 2）、踝关节前方（n = 2）和足背（n = 1）软组织缺损的患者，采用以远端为蒂的腓肠神经营营皮瓣进行缺损覆盖手术。所有病例均作为二期手术进行。
除5例轻微并发症外，所有皮瓣均显示出良好效果。3例皮瓣出现表浅皮肤坏死，2例出现部分皮瓣尖端坏死。
以远端为蒂的腓肠神经营营皮瓣在覆盖小腿、足跟和足背缺损方面非常有用。它可靠，易于切取，对患者的损伤最小。该皮瓣不牺牲肢体的任何主要血管，因此是一种非常安全的皮瓣。
