Repair of lateral calcaneal wound with the lateral supramalleolar flap pedicled with the end perforator of peroneal artery
10.3760/cma.j.issn.1001-2036.2019.05.010
- VernacularTitle:腓动脉终末穿支外踝上皮瓣修复足跟外侧创面
- Author:
Yingjie XIONG
1
;
Chaofeng XING
;
Zhiyu HU
;
Ke SONG
;
Guangxian ZHU
;
Feicheng CANG
;
Mingwu ZHOU
Author Information
1. 中国人民解放军第九八八医院全军创伤骨科中心
- Keywords:
Lateral supramalleolar flap;
Perforator of peroneal artery;
Repair;
Heel wound;
Microsurgi-cal technique
- From:
Chinese Journal of Microsurgery
2019;42(5):459-462
- CountryChina
- Language:Chinese
-
Abstract:
To explore the method and effect of repairing the soft tissue defect of the lateral heel with the retrograde lateral supramalleolar flap pedicled with the end perforator of peroneal artery. Methods From May, 2015 to February, 2018, 16 cases of lateral calcaneal soft tissue defect were repaired with the retrograde lateral supramalleolar flap pedicled with the end perforator of peroneal artery.All wounds were treated with one-stage dilata-tion and VSD to control infection. In cases of chronic calcaneal bone infection, the bone defect formed after extensive resection of infected bone was temporarily filled with antibiotic bone cement. The area of soft tissue defect on the lat-eral heel was 3.0 cm×2.0 cm-8.0 cm×5.0 cm, and the area of flaps was 3.5 cm×2.5 cm-8.5 cm×5.5 cm. The small donor area of the flap was sutured directly, and the larger area was repaired by skin grafting. Patients with chronic calcaneal bone infection underwent bone cement removal and autogenous bone transplantation after inducing mem-brane formation 6 to 8 weeks after flap transplantation. All cases were followed-up, including 7 cases outpatient fol-low-up and 9 telephone follow-up. Results All the 16 flaps survived smoothly. The donor and recipient areas of the flaps healed primarily. All cases were followed-up for 3 to 13 months. The flaps had good shape, no swelling, similar color to heel skin and no pigmentation.Ankle flexion and extension were not restricted.Four cases with chron-ic osteomyelitis of calcaneus healed well after second-stage bone grafting, with an average healing time of 8.5 months. Conclusion The retrograde lateral supramalleolar flap with the end perforator of peroneal artery is an ideal method for repairing the soft tissue defect on the lateral heel with simple operation and reliable blood supply.
