Department of Burns & Plastic Surgery, All India Institute of Medical Sciences (AIIMS), Phulwarisharif, Patna 801507, India.
Department of Burns & Plastic Surgery, All India Institute of Medical Sciences (AIIMS), Phulwarisharif, Patna 801507, India.
J Plast Reconstr Aesthet Surg. 2021 Nov;74(11):2957-2964. doi: 10.1016/j.bjps.2021.03.082. Epub 2021 Apr 23.
Defects on the dorsum of the foot remain a reconstructive challenge for plastic surgeons. There are very few pedicled flaps that have a reach up to the distal foot and those too with a threat of poor perfusion. Very often distal foot has to be resurfaced with free flap even with small defects. This study describes our experience with the reverse extensor digitorum brevis muscle (EDB) flap for small- to medium-sized defects on the dorsum of the foot.
The study was conducted on 12 patients between February 2018 and March 2020 who presented with defects on the dorsum of the foot. The mean age of the patients was 30.8 years and the mean defect size was 20.17 cm. The EDB was applied on 10 male and 2 female subjects and resurfaced with a split thickness skin graft. The donor site was closed primarily.
All flaps survived well. Two patients had small graft loss and 2 partial wound dehiscence of donor site, all of which healed on conservative treatment. Three patients had temporary sensory disturbance which resolved in few weeks.
The reverse EDB flap is a reliable flap for the coverage of small- to medium-sized dorsal foot defects. The flap has the advantage of robust vascularity, expendable muscle with little donor site morbidity, an easy to learn technique, short operating time, and acceptable esthetic outcome, and it can be used as the primary option in cases of small to medium dorsal foot defects.
足部背侧的缺损仍然是整形外科医生面临的重建挑战。能够到达足部远端的带蒂皮瓣很少,而且这些皮瓣的灌注也存在威胁。即使是较小的缺损,远端足部也常常需要用游离皮瓣来覆盖。本研究描述了我们使用反向趾短伸肌(EDB)皮瓣治疗足部背侧小至中等大小缺损的经验。
本研究纳入了 2018 年 2 月至 2020 年 3 月期间 12 例足部背侧缺损患者。患者的平均年龄为 30.8 岁,平均缺损大小为 20.17cm。10 名男性和 2 名女性患者应用 EDB,并用断层皮片覆盖。供区直接缝合。
所有皮瓣均存活良好。2 例患者有小面积皮片坏死,2 例供区部分伤口裂开,均经保守治疗愈合。3 例患者有暂时性感觉障碍,数周后缓解。
反向 EDB 皮瓣是覆盖小至中等大小足部背侧缺损的可靠皮瓣。该皮瓣具有血管丰富、可扩张肌肉、供区并发症少、易于学习、手术时间短、美容效果可接受等优点,可作为小至中等大小足部背侧缺损的首选治疗方法。