Hemodynamic factors related to complications of trans pedicled peroneal perforator flap
10.3760/cma.j.issn.1009-4598.2019.12.012
- VernacularTitle: 跨区带蒂腓动脉穿支皮瓣局部并发症血流动力学相关原因分析
- Author:
Yi XU
1
;
Yangjian WANG
1
;
Zhiwu CHEN
2
;
Zuguang HUA
1
;
Maolin TANG
3
;
Peng WEI
1
Author Information
1. Department of Plastic Surgery, Ningbo First Hospital, Ningbo 315010, China
2. Medical College of Ningbo University, Ningbo 315211, China
3. Wenzhou Medical University, Wenzhou 325035, China
- Publication Type:Journal Article
- Keywords:
Hemodynamics;
Pedicled skin flap;
Flap design
- From:
Chinese Journal of Plastic Surgery
2019;35(12):1221-1225
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the causes of local necrosis and hemodynamics after pedicle peroneal perforator flap and try to find out prevention strategies.
Methods:Retrospective 17 tissue defect cases admitted by Plastic and Reconstructive Surgery of Ningbo First Hospital, which treated by pedicle perforator flap with kinds of complications. 3 of 17 were naked the perforators to reduce reverse pressure. Patients involved 12 male, 5 female, ages from 22 to 46, with defected area from 5.0 cm×11.0 cm to 8.0 cm×14.0 cm, located in lateral ankle.
Results:3 to 5 days postoperative 12 cases with distal local necrosis, all of which were designed interregional, one with performator naked, turned back after drainage and wound dressing, 3 cases were gradually swelling and purple postoperative, two of them were perforator naked. 1 weeks later, the distal skin of flap necrosis and were gradually turning black scab appeared.With scab cutting and fascia survived, no bony tissues exposure, after 0.5% povidone iodine wet dressing regularly, endothelial cells crawled to cover. 2 cases with larger ranger of swelling and purple, not be better even pedicale releasing was conducted, 2 weeks later most part of the flap necrosis and the distal turned black eschar. After debridement and skin grafting, wounds healed later.All patients were followed up for 3 months with no flap transplantation required.
Conclusions:Coaxial homology, within 2 choke vessel areas, perforator skeletonization, kick out the small saphenous vein, might be the ways to reduce the complication of the cross area designing trans pedicled peroneal perforator flap.
