Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Microsurgery. 2024 Jan;44(1):e31044. doi: 10.1002/micr.31044. Epub 2023 Mar 31.
The free peroneal artery perforator (FPAP) flap is used for soft tissue defects after burns and trauma. However, the use of FPAP flaps to repair limb soft tissue defects for immediate reconstruction was rarely reported previously. Therefore, the purpose of this report is to evaluate free peroneal artery perforator flap to reconstruct traumatic limb soft tissue defects for immediate reconstruction.
A total of 25 cases of limb soft tissue defects undergoing immediate reconstruction of FPAP flap transfer were retrospectively evaluated from January 2019 to June 2019 in our institute. The locations of defects included the palm (10 cases), finger (5 cases), foot (7 cases), ankle (2 cases) and wrist (1 case). The sizes of defect varied from 3 × 2 cm to 15 × 7 cm (54.1 cm in average). Flaps were harvested based on the peroneal perforator vessels, initially marked using hand-held Doppler.
Average size of harvested flap was 9.7 × 6.2 cm (ranging from 3.5 × 2 cm to 16 × 8 cm). All perforators were harvested from the peroneal artery and the arterial diameter ranged from 0.8 to 1.7 mm. The average pedicle length was 3.04 cm (range, 1.85-4.75 cm). Five vascular thrombosis were found including three cases of arterial thrombosis and two cases of venous thrombosis which were successfully salvaged by re-operation and vein graft. Satisfying functional outcome and acceptable appearance were achieved at 6 months or longer after surgery (range, 6-15 months, 12 months in average). All flaps survived at the end-point.
The FPAP flap is a reliable and thin fasciocutaneous flap, which can be used for repairing limb soft tissue defects. The FPAP flap can be used for covering defects with various appearances, locations, and sizes.
游离腓动脉穿支皮瓣（FPAP 皮瓣）用于烧伤和创伤后的软组织缺损。然而，以前很少有报道使用 FPAP 皮瓣修复四肢软组织缺损进行即刻重建。因此，本报告旨在评估游离腓动脉穿支皮瓣修复创伤性四肢软组织缺损进行即刻重建的效果。
回顾性分析 2019 年 1 月至 2019 年 6 月在我院行 FPAP 皮瓣转移即刻重建的 25 例四肢软组织缺损患者的临床资料。缺损部位包括手掌（10 例）、手指（5 例）、足（7 例）、踝（2 例）和腕（1 例）。缺损面积为 3cm×2cm 至 15cm×7cm（平均 54.1cm）。皮瓣根据腓动脉穿支血管进行游离，术前使用手持式多普勒进行初步标记。
切取皮瓣的平均大小为 9.7cm×6.2cm（范围为 3.5cm×2cm 至 16cm×8cm）。所有穿支均发自腓动脉，动脉直径为 0.8 至 1.7mm。蒂部平均长度为 3.04cm（范围为 1.85cm 至 4.75cm）。术后发现 5 例血管血栓形成，其中动脉血栓 3 例，静脉血栓 2 例，经再次手术和静脉移植后成功挽救。术后 6 个月或更长时间（范围为 6 至 15 个月，平均 12 个月）获得满意的功能和可接受的外观。所有皮瓣均存活至研究终点。
FPAP 皮瓣是一种可靠的、薄的筋膜皮瓣，可用于修复四肢软组织缺损。FPAP 皮瓣可用于覆盖各种形态、位置和大小的缺损。
