Mégevand Vladimir, Scampa Matteo, Suva Domizio, Kalbermatten Daniel F, Oranges Carlo M
Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland.
Department of Plastic Surgery, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, United Kingdom.
JPRAS Open. 2024 Jun 18;41:230-239. doi: 10.1016/j.jpra.2024.06.008. eCollection 2024 Sep.
Soft tissue defects of the distal third of the leg are challenging and management with simple split thickness skin graft or conservative measures is often difficult. The peroneus brevis muscle flap is well described in the literature to cover such defects. The aim of our study was to review the different applications and potential complications of the peroneus brevis muscle flap. A comprehensive review of all existing evidence on the use of peroneus brevis muscle flaps for coverage of defects in the distal third of the leg in adult populations was performed. Two hundred forty-eight records were identified in the literature search, among which 15 met the PICOS (Patient, Intervention, Comparison, Outcome and Study design) criteria. All selected studies were retrospective. Overall, 222 patients who received peroneus brevis muscle flaps were analyzed. Indications for reconstruction were post-traumatic defects, infected wounds, and chronic wounds. The overall complication rate was 21% (46/222) with the most commonly reported complication being skin graft loss. We observed 2 cases of partial flap loss, 17 cases of skin graft loss, 2 cases of post-operative hematoma, 2 cases of recurrent infection, 12 cases of partial flap necrosis, 3 cases of skin graft necrosis, and 8 cases of delayed wound healing. Overall, 16 patients (7%) required revision surgery. No cases of donor site morbidity were described. The current review shows that the peroneus brevis muscle flap is a versatile and reliable option for the coverage of small to medium sized defects of the distal leg, ankle, and foot with low complication rates and donor site morbidity.
小腿远端三分之一的软组织缺损具有挑战性，采用简单的中厚皮片移植或保守措施进行治疗往往很困难。文献中对腓骨短肌肌瓣覆盖此类缺损有详细描述。我们研究的目的是回顾腓骨短肌肌瓣的不同应用及潜在并发症。对所有关于在成年人群中使用腓骨短肌肌瓣覆盖小腿远端三分之一缺损的现有证据进行了全面综述。在文献检索中识别出248条记录，其中15条符合PICOS（患者、干预措施、对照、结局和研究设计）标准。所有入选研究均为回顾性研究。总体而言，对222例接受腓骨短肌肌瓣治疗的患者进行了分析。重建的适应证为创伤后缺损、感染性伤口和慢性伤口。总体并发症发生率为21%（46/222），最常报告的并发症是皮片丢失。我们观察到2例部分肌瓣丢失、17例皮片丢失、2例术后血肿、2例反复感染、12例部分肌瓣坏死、3例皮片坏死和8例伤口愈合延迟。总体而言，16例患者（7%）需要进行翻修手术。未描述供区并发症的病例。当前综述表明，腓骨短肌肌瓣是覆盖小腿远端、踝关节和足部中小型缺损的一种通用且可靠的选择，并发症发生率和供区并发症较低。
