Repair of soft tissue defects in foot weight-bearing area with advancement medial plantar artery perforator flap
10.3760/cma.j.cn114453-20210121-00037
- VernacularTitle:含足底内侧动脉穿支血管的筋膜岛状皮瓣推进修复足底负重区软组织缺损
- Author:
Yan CHANG
1
;
Yanling WANG
;
Junmei YAN
;
Sanliang LI
Author Information
1. 潍坊市益都中心医院手足外科 262500
- Keywords:
Angiography;
Perforator flap;
Reconstructive surgical procedures;
Sole of foot
- From:
Chinese Journal of Plastic Surgery
2021;37(6):645-651
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of repairing soft-tissue defect of foot weight-bearing area with the help of CT angiography (CTA) using medial plantar artery perforator (MPAP) flap.Methods:This was a retrospective study spanning over a period, from May 2011 to October 2019, conducted at the Yidu Central Hospital of Weifang. The data was focused on the cases of soft tissue defect in plantar bearing area repaired by fascial island skin flap containing a perforating branch of the medial plantar artery perforator. CTA of the foot was performed before procedure. The 3D digital model was reconstructed by computer software to explore the number, diameter, course, and distribution of perforating vessels in the donor site, and a personalized repair scheme was designed to match the shape and size of recipient site. The outcome of the flap repair, foot function, and sensory function were followed up. Pared-sample t-test was used to compare the difference of perforator vessel diameter and the distance from heel margin to perforator branch between preoperative and intraoperative actual measurement by CTA. Results:A total of 9 patients were enrolled, including 5 males and 4 females. The mode for age group were 41 (range, 16-65 years). The area of the wound defect was 2.0 cm×2.0 cm-4.0 cm×5.0 cm, and the size of perforator fascial skin flap was 6.0 cm × 4.0 cm -12.0 cm × 8.0 cm. All the 9 flaps were survived and followed up for half a year to 5 years. All the patients were satisfied with the outcomes, the satisfaction score of flap efficacy was 8.7±3.1. Outcomes were evaluated according to the foot function scoring criteria: 3 cases were excellent, 5 cases were good, and 1 case was medium. Sensory recovery reached S4 in 3 cases, S3 in 5 cases, and S2 in 1 case. There were 4 cases in R4, 4 cases in R3, and 1 case in R2. There was no significant difference between the preoperative measurement of perforator diameter and the distance between the heel edge and perforator ( P>0.05). Conclusions:The MPAP flap is simple, safe and easy to operate. It is one of the ideal methods to repair the soft tissue defects in small and medium-sized areas of the foot weight-bearing area.
