Palukuri Lakshmi, Srinivas Sreedharala, Madhulika Dharmapuri, Pawde Sanujit, Sebastian Ajo, Sankar Swathi, Chintha Sandeep Reddy
Department of Plastic Surgery, Osmania Medical College and Hospital, Hyderabad, India.
Department of Neurosurgery, Osmania Medical College and Hospital, Hyderabad, India.
J Trauma Inj. 2023 Dec;36(4):369-375. doi: 10.20408/jti.2023.0042. Epub 2023 Nov 23.
The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects.
This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up.
There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm, and extensive defects as large as 16 cm × 14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm, and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases.
The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.
膝关节及小腿近三分之一处缺损的重建需要薄而柔韧的皮肤以及稳定且有感觉功能的软组织覆盖。本研究分析了以近端为蒂的腓肠动脉皮瓣用于覆盖此类缺损的情况。
这项前瞻性临床干预研究纳入了10例膝关节及小腿近三分之一处存在软组织缺损的患者。这些患者接受了以近端为蒂的腓肠动脉皮瓣重建手术。该研究分析了多种因素，包括年龄、性别、病因、缺损的位置和表现、缺损尺寸、皮瓣细节、术后并发症及随访情况。
共10例患者，均为年龄在20至65岁的男性。最常见的损伤原因是道路交通事故导致的创伤。大多数缺损位于小腿近三分之一处，尤其是在前外侧。缺损尺寸从6×3厘米至15×13厘米不等，使用该皮瓣可覆盖达16厘米×14厘米的大面积缺损。皮瓣大小从7×4厘米至16×14厘米不等，蒂长为10至15厘米。所有病例中，供区均采用中厚皮片移植闭合。该皮瓣始终能为缺损提供薄而柔韧、稳定且持久的软组织覆盖，无功能缺陷，供区并发症极少。有两例出现了包括皮瓣远端坏死和供区植皮失败在内的并发症。
以近端为蒂的腓肠筋膜皮瓣是重建膝关节及小腿近三分之一处中至大型软组织缺损的主要方法。该技术可提供薄、可靠、有感觉功能且稳定的软组织覆盖，能以最少的并发症覆盖较大的缺损。
