Cho Álvaro Baik, Ferreira Carlos Henrique Vieira, de Mendonça Priscilla Goes Medea, Sorrenti Luiz, Kiyohara Leandro Yoshinobu
Universidade de São Paulo, Instituto de Ortopedia e Traumatologia, Department of Hand Surgery and Microsurgery (IOT-FMUSP), São Paulo, SP, Brasil.
Faculdade de Medicina do ABC, Department of Hand Surgery and Microsurgery, Santo Ándre, SP, Brazil.
Acta Ortop Bras. 2023 Apr 17;31(spe1):e257850. doi: 10.1590/1413-785220233101e257850. eCollection 2023.
The aim was to evaluate the viability and the outcomes of the sural flap performed with the pedicle covered by a strip of skin.
A prospective cohort of 20 consecutive cases were evaluated in terms of flap viability, complication rate, and the amount of skin graft required. The location of the defects was the middle third of the tibia in 3 cases, the ankle and hindfoot in 15 cases, the middle foot in 1 case, and the forefoot in 1 case. The flap design was the same as described by Masquelet. The only modification included a strip of skin over the entire length of the pedicle. The intermediary skin between the donor site and the defect was incised and the skin was undermined to accommodate the pedicle without compression.
All cases had a satisfactory evolution, with adequate healing and without flap loss. Both the donor site and the pedicle were primarily closed in all cases. In one patient, the flap developed a limited area of superficial epidermolysis that healed spontaneously.
the modified sural flap with a covered pedicle is feasible and reliable with a lower rate of complications when compared with the conventional sural flap. .
评估带蒂腓肠神经营养血管皮瓣覆盖一条皮肤条带时的存活情况及效果。
对连续20例患者进行前瞻性队列研究，评估皮瓣存活情况、并发症发生率及所需植皮量。缺损部位：3例位于胫骨中1/3，15例位于踝及后足，1例位于中足，1例位于前足。皮瓣设计与Masquelet所述相同。唯一的改进是在蒂的全长覆盖一条皮肤条带。切开供区与缺损之间的中间皮肤，并对皮肤进行潜行分离以容纳蒂而不产生压迫。
所有病例病情进展均令人满意，愈合良好，无皮瓣坏死。所有病例供区和蒂均一期闭合。1例患者皮瓣出现局限性浅表表皮松解，自行愈合。
与传统腓肠神经营养血管皮瓣相比，带蒂覆盖的改良腓肠神经营养血管皮瓣可行且可靠，并发症发生率较低。
