Acute vascular complications (flap necrosis and congestion) with one stage and two stage distally based sural flap for wound coverage around the ankle
- Author:
Nazri Mohd Yusof
;
Ahmad Fadzli Sulong
;
Wan Azman Wan Sulaiman
;
Mohammed Azril Mohammed Amin
- Publication Type:Journal Article
- Keywords:
Wounds;
pedicled flap;
postoperative complications
- From:
The Medical Journal of Malaysia
2016;71(2):47-52
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The understanding of the skin’s vascular
anatomy has improved in the last decade. It has lead to
technique modification such as the staged procedure in
performing sural flaps and improvement in the flap survival
rate. The aim of this study was to evaluate the acute vascular
complications (flap necrosis or congestion) of 29 patients
who underwent distal base sural flap for coverage of wound
around the ankle.
Methods: Twenty-four males and five females with a mean
age of 37.1 years old underwent sural flap surgery to cover
wounds at around the ankle. There were 12 cases of open
fracture, five infected fractures, four spoke injuries, four
degloving injuries and four diabetic foot ulcers. Twentythree
cases were done as a single stage procedure while six
as a two-stage procedure. The flaps were tunnelled under
the skin in three cases.
Results: Twenty one flaps healed uneventfully, seven acute
vascular complications occur in a single stage group: five
developed partial necrosis, one had congestion with
epidermolysis, and one had complete flap necrosis.
Complications were treated by dressing or skin grafting and
only one required a repeat flap surgery.
Conclusions: Acute vascular complications may be
minimised when sural flap is done in stages for elderly,
diabetic, smokers and/or patients with large wound around
the ankle. Even if the flap appears necrotic, the underlying
structure may still be covered as the fasciosubcutaneous
layer of the flap may still survive.
- Full text:P020160623503300320200.pdf
