Balakrishnan Thalaivirithan Margabandu, Ramkumar Jayagosh, Jaganmohan Janardhanan
Department of Plastic and Faciomaxillary Surgery, Madras Medical College, Chennai, Tamil Nadu, India.
Indian J Plast Surg. 2017 Sep-Dec;50(3):281-287. doi: 10.4103/ijps.IJPS_67_17.
Lower third leg soft tissue defects with anatomical and pathological constraints are posing formidable challenges to reconstructive surgeon.
This retrospective study was conducted to assess the effectiveness of posterior tibial vessels perforator-propeller flaps for the reconstruction of small and medium sized soft tissue defects in the lower third leg.
22 patients (16 were males and 6 were females) were involved in this study between period of January 2012 and December 2016.We followed the protocol of initial non delineating exploratory incision made to find out single best perforator in all patients. All the defects in leg reconstructed with adhoc posterior tibial vessel propeller flaps.
All 22 flaps survived well. All in an average of 13 months follow up period, had pain free walking, with minimal scarring and acceptable aesthesis at the reconstruction sites with no need for any secondary procedure.
With inability of preoperatively dopplering the perforators in the lower third leg region, the exploratory posterior nondelineating incision was used in all cases to secure the single best perforator for the propeller flaps. Thus adhoc posterior tibial vessel propeller flaps are dependable, easily adoptable for the reconstruction of soft tissue defects of the lower third leg region.
小腿下段存在解剖和病理限制的软组织缺损,给重建外科医生带来了巨大挑战。
本回顾性研究旨在评估胫后血管穿支推进皮瓣修复小腿下段中小型软组织缺损的有效性。
2012年1月至2016年12月期间,本研究纳入了22例患者(男性16例,女性6例)。我们遵循了在所有患者中先做非标记性探查切口以找出最佳穿支的方案。小腿所有缺损均采用个体化的胫后血管推进皮瓣进行修复。
22例皮瓣全部顺利存活。在平均13个月的随访期内,所有患者行走时均无疼痛,重建部位瘢痕轻微,感觉尚可,无需进行任何二次手术。
由于术前无法用多普勒探测到小腿下段区域的穿支,所有病例均采用非标记性后探查切口来确定推进皮瓣的最佳穿支。因此,个体化的胫后血管推进皮瓣可靠,易于用于修复小腿下段区域的软组织缺损。