Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China.
Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China.
J Orthop Surg Res. 2021 Jan 13;16(1):52. doi: 10.1186/s13018-021-02206-x.
No large series have analysed distally based sural fasciocutaneous (DBSF) flaps in paediatric patients. The aims of this study were to assess the reliability and analyse the potential risk factors for these flaps and to describe complications in the donor site and the functional follow-up results.
Between June 2002 and November 2017, 88 DBSF flaps were used to reconstruct soft tissue defects in paediatric patients. Potential risk factors, reconstruction outcomes, and complications in the donor site of the flaps were analysed.
Among the 88 flaps, partial necrosis developed in 8 flaps (9.1%). The partial necrosis rate was significantly higher in flaps with the top edge located in the 9th zone (26.1%), with a length-width ratio (LWR) ≥ 5:1 (28.6%), and with a dimension of the skin island ≥ 100 cm (22.7%). Partial necrosis did not occur in flaps with a dimension of the skin island < 80.0 cm or with a skin-island width < 7.0 cm. The reconstruction outcomes in most paediatric patients were evaluated as "excellent" or "good". The incidence of obvious scarring was higher in the donor site.
Partial necrosis of DBSF flaps will significantly increase when the top edge of the flap is located in the 9th zone, when the LWR of the flap is ≥ 5:1, or when the dimension of the skin island is ≥ 100.0 cm. Flaps with a skin-island width < 7.0 cm or with a dimension of the skin island < 80 cm are relatively safe and reliable.
目前尚无大型研究分析儿童患者应用远端蒂腓肠神经营养血管皮瓣（DBSF）的情况。本研究旨在评估该皮瓣的可靠性，分析其潜在的风险因素，并描述皮瓣供区并发症及功能随访结果。
2002 年 6 月至 2017 年 11 月，我们采用 88 个 DBSF 皮瓣修复儿童患者的软组织缺损。分析潜在的风险因素、皮瓣重建效果及皮瓣供区并发症。
88 个皮瓣中，8 个（9.1%）发生部分坏死。皮瓣顶位于第 9 区、长宽比（LWR）≥5:1、皮岛面积≥100cm 的皮瓣，其部分坏死发生率明显更高（分别为 26.1%、28.6%、22.7%）。皮岛面积<80cm 或皮岛宽度<7.0cm 的皮瓣无部分坏死发生。大多数患儿的重建效果评估为“优秀”或“良好”。供区的显著瘢痕发生率较高。
当皮瓣顶位于第 9 区、LWR≥5:1 或皮岛面积≥100cm 时，DBSF 皮瓣的部分坏死风险会显著增加。皮岛宽度<7.0cm 或皮岛面积<80cm 的皮瓣相对安全可靠。
