IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Policlinico di Modena Azienda Ospedaliero-Universitaria di Modena, Modena, Emilia-Romagna, Italy.
Int J Low Extrem Wounds. 2022 Dec;21(4):436-442. doi: 10.1177/1534734620951540. Epub 2020 Aug 26.
The aim of this single-center, retrospective study is to demonstrate the effectiveness of distally based peroneus brevis muscle flap as first therapeutic option for infections after Achilles tendon open repair. We retrospectively analyzed 14 consecutive patients with complete Achilles tendon rupture and developing surgical site infection after an attempt of open surgical repair. Every patient was reconstructed with distally base peroneus brevis muscle flap. The primary outcome was the return to work and the initiation of full weight-bearing. Secondary outcomes were complication rate and time needed to return to work. A review of the literature was conducted to better define the actual standard treatment. Each patient returned to work. No flap necrosis occurred. Two minor healing delays and one hematoma were reported. Median time to wound healing was 17 days (interquartile range [IQR] = 13-20). Median time to full weight-bearing was 52 days (IQR = 47-55). Median follow-up (FU) was 21 months. Distally based peroneus brevis flap is a safe treatment for surgical site infections after Achilles tendon rupture repair. Patients regained full weight-bearing after a median time of 52 days from the surgical reconstruction. No major complications were observed. This flap clearly emerges as first reconstructive option for complications after surgery of Achilles tendon region.
本单中心回顾性研究旨在展示腓骨短肌皮瓣作为跟腱开放性修复后感染的首选治疗方法的有效性。我们回顾性分析了 14 例连续的完全跟腱断裂患者，这些患者在尝试开放性手术修复后出现了手术部位感染。每位患者均采用腓骨短肌皮瓣进行重建。主要结局是恢复工作和开始完全负重。次要结局是并发症发生率和恢复工作所需的时间。我们进行了文献复习，以更好地确定实际的标准治疗方法。每位患者均恢复工作，无皮瓣坏死。报告了 2 例轻微愈合延迟和 1 例血肿。伤口愈合的中位数时间为 17 天（四分位距 [IQR]=13-20）。完全负重的中位数时间为 52 天（IQR=47-55）。中位随访时间为 21 个月。腓骨短肌皮瓣是治疗跟腱断裂修复后手术部位感染的一种安全方法。患者在接受手术重建后 52 天中位数时间内恢复完全负重。未观察到重大并发症。这种皮瓣显然是跟腱区域手术后并发症的首选重建方法。
