Repair the large area soft tissue defect of foot and ankle with free bilateral anterolateral femoral perforator flap in series
10.3760/cma.j.issn.1001-2036.2018.05.009
- VernacularTitle:游离双侧股前外侧穿支皮瓣串联修复足踝部大面积软组织缺损
- Author:
Huanwei SUN
1
;
Yiming ZHONG
;
Hongquan ZHANG
;
Chunsheng WANG
Author Information
1. 大连医科大学附属大连市中心医院手足外科
- Keywords:
Foot;
Ankle;
Anterolateral femoral perforator flap;
Repair;
Microsurgical operation
- From:
Chinese Journal of Microsurgery
2018;41(5):450-453
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of free bilateral anterolateral femoral perforator flap in repairing large area soft tissue defects of foot and ankle. Methods From July, 2013 to December, 2017, 30 pa-tients (19 males and 11 females) with large soft tissue defects of ankle and foot were treated , aged 21-52 years. The defects were located in the middle and distal part of the foot and ankle, the wounds were all exposed with bone, ten-don or internal fixator, and the area of skin defect was 15 cm × 22 cm-19 cm× 28 cm. All of them were repaired by free bilateral anterolateral femoral perforator flaps. The perforating branch of bilateral flap was determined by CDU or DSA before operation. According to the area of skin defect and the shape of wound, an appropriate perforating branch flap was designed in the anterolateral thigh region. One perforating branch flap was used as the proximal series flap, the proximal vessel pedicle was anastomosed with the recipient region arteriovenous flap. The other perforating branch flap was used as the distal series flap, the artery and vein were anastomosed between the two flaps. The total area of the two flaps was 17 cm × 25 cm-23 cm × 32 cm. The survival of the flap and the functional recovery of the repair site were observed and the clinical effect was evaluated. Results There was no vascular crisis after operation, and the flaps survived. Followed-up for 5-28(mean, 13.5)months showed that the flap had good blood flow, soft texture and good elasticity, among which 4 cases were slightly bloated and improved after plastic operation. After operation, 26 cases were excellent (90-100 points), 4 cases were good (75-89 points), and the average score of AOFAS was 93.8 points. Conclusion The traffic accident of anterolateral perforating branch and the attention in the process of flap cutting and series were summarized.
