Song Dajiang, Li Zan, Zhou Xiao, Chi Zhenglin, Zhou Xin
Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Changsha Hunan, 410008, P.R.China.
Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Changsha Hunan, 410008,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Nov 15;31(11):1363-1366. doi: 10.7507/1002-1892.201705126.
To investigate the clinical application of relaying lateral gastrocnemius artery perforator flap in reconstruction of the donor defect after distally sural flap transferring.
Between January 2014 and January 2016, 12 cases with foot and ankle defects were treated. There were 10 males and 2 females with an average age of 23.4 years (mean, 14-52 years). The injury was caused by motorcycle accident in 7 cases and traffic accident in 5 cases. The injury located at left limb in 7 cases and right limb in 5 cases. The size of soft tissue ranged from 10 cm×4 cm to 12 cm×6 cm. The disease duration was 2-84 hours (mean, 26.2 hours). The foot and ankle defects were reconstructed by distally sural flaps, then the flap donor sites were reconstructed with relaying lateral gastrocnemius artery perforator flap at the same stage. The size of distally sural flap ranged from 11 cm×5 cm to 13 cm×7 cm. The size of relaying flap ranged from 7 cm×4 cm to 10 cm×6 cm.
All flaps survived uneventfully. All recipient sites and donor sites healed smoothly. No vascular crisis, wound dehiscence, or evident swelling occurred. All patients were followed up 6-14 months (mean, 12.4 months) with satisfied esthetic and functional results in recipient and donor sites. There were only linear scar on the donor sites. The color and contour was satisfying, the function of calf and foot were not affected.
The relaying lateral gastrocnemius artery perforator flap combined with distally sural flap is an idea choice to reconstruct foot and ankle defect, which can avoid donor site skin grafting, minimize donor site morbidity.
探讨腓肠外侧动脉穿支接力皮瓣在腓肠神经营养血管远端蒂皮瓣供区创面修复中的临床应用。
2014年1月至2016年1月,收治足踝部软组织缺损患者12例,男10例,女2例,平均年龄23.4岁(14~52岁)。致伤原因:摩托车伤7例,交通事故伤5例;左侧肢体损伤7例,右侧肢体损伤5例。软组织缺损面积10 cm×4 cm~12 cm×6 cm,伤后至手术时间2~84小时,平均26.2小时。均采用腓肠神经营养血管远端蒂皮瓣修复足踝部软组织缺损,同期采用腓肠外侧动脉穿支接力皮瓣修复供区创面。腓肠神经营养血管远端蒂皮瓣面积11 cm×5 cm~13 cm×7 cm,腓肠外侧动脉穿支接力皮瓣面积7 cm×4 cm~10 cm×6 cm。
所有皮瓣均顺利成活,受区与供区创面均一期愈合,未发生血管危象、伤口裂开及明显肿胀。所有患者均获随访,随访时间6~14个月,平均12.4个月,受区与供区外形与功能满意。供区仅遗留线状瘢痕,颜色、外形良好,小腿及足部功能未受影响。
腓肠外侧动脉穿支接力皮瓣联合腓肠神经营养血管远端蒂皮瓣是修复足踝部软组织缺损的理想选择,可避免供区植皮,减少供区并发症。