Clinical application of 3 types of the medial shank island flaps
10.3760/cma.j.issn.1001-2036.2020.01.003
- VernacularTitle:三种不同形式的小腿内侧岛状皮瓣临床应用分析
- Author:
Yuxuan ZHANG
1
;
Yajun XU
;
Yi CUI
;
Jiandong ZHOU
;
Xingfei ZHANG
;
Wencheng WANG
Author Information
1. 江苏省无锡市第九人民医院足踝外科 214000
- From:
Chinese Journal of Microsurgery
2020;43(1):5-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the application and results in repairing wounds on shank and medial malleolus by perforator pedicled middle and lower third of posterior tibial flap, saphenous neurovascular flap and posterior tibial artery perforator plus saphenous neurovascular (double blood supply) flap.Methods:Clinical data of 60 patients with wounds on shank and medial malleolus and treated between August, 2015 and December, 2018 were analyzed. Among the patients, 25 were treated with perforator pedicled middle and lower third of posterior tibial flaps, 15 with saphenous neurovascular flaps, and 20 with double blood supply flaps. The data of surgery, survival of the flaps, texture and swelling of the flaps, patient satisfaction and scores set by American Orthopaedic Foot and Ankle Society(AOFAS) were collected. Statistic analysis was carried out to compare observations among the 3 groups.Results:Postoperative followed-up was 6 to 24(average 13.4) months. One flap suffered insufficient blood supply in the group of perforator pedicled middle and lower third of posterior tibial flaps, 2 flaps suffersd necrosis and skin graft was carried out in reverse saphenous nerve neurocutaneous flaps group. In double blood supply flaps group, 2 flaps appeared purple after surgery, and improved after removing the pedicle sutuer, and flaps became swelling and received secondary repair. All AOFAS scores (93.8, 93.3 and 92.8, respectively) and patient satisfaction were high in all 3 groups.Conclusion:All 3 types of flap are able to be used in repairing the soft tissue defect on shank and medial malleolus. The inclusive of saphenous nerve should be determined in intraoperation according to the presence and size of the perforator. If artery perforation is reliable, the use of posterior tibial artery perforator flap in wound repairing will deliver satisfactory outcomes in terms of blood supply and appearance of the flap. For the wider area of wound, a flap with double blood supply is preferred.
