Repair of multiple defects of foot and ankle with lobulated chimeric perforator flap pedicled with descending branch of lateral femoral circumflex artery: Report of 6 cases
10.3760/cma.j.cn441206-20220214-00032
- VernacularTitle:以旋股外侧动脉降支为蒂的分叶-嵌合穿支皮瓣修复足踝多部位缺损伤六例
- Author:
Wenyi WU
1
;
Shaoxiao YU
;
Wanggao ZHOU
;
Zhenwei ZHANG
Author Information
1. 深圳市中西医结合医院手外科，广东 深圳 518104
- Keywords:
Descending branch of lateral circumflex femoral artery(d-LCFA);
Chimeric perforator flap;
Lobulated perforator flap;
Foot and ankle;
Microsurgical operati
- From:
Chinese Journal of Microsurgery
2022;45(4):400-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of lobulated chimeric perforator flap pedicled with descending branch of lateral circumflex femoral artery (d-LCFA) in repair of multiple composite tissue defects of the foot and ankle.Methods:From February 2017 to March 2021, a total of 6 patients with foot and ankle multiple site deficiency injuries were treated in the Department of Hand Surgery, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine. The area of the soft tissue defect was 14.0 cm×9.0 cm~28.0 cm×9.0 cm. The size of the flap were 15.0 cm×10.0 cm-29.0 cm×10.0 cm. In all the cases, the wounds were complicated with bone defects and different degrees of infection. After primary debridement, VSD was used for continuous lavage and drainage. In the second stage, the defect was repaired with a lobulated chimeric perforator flap of d-LCFA. The colour, texture and sensory recovery of flap were observed in the scheduled postoperative follow-up.Results:All flaps survived smoothly without vascular crisis. After 10-12 months of follow-up, no recurrence of infection was found. The flaps had no pigmentation, soft in texture, with non-bloated appearance, good wear resistance, and recovered part of sensation. According to the British Medical Research Council (BMRC) hand sensory function evaluation standard, the sensation recovered to S 1-S 2. Conclusion:The lobulated chimeric perforator flap pedicled with d-LCFA only requires microanastomosis with 1 vascular pedicle. It simultaneously covers wounds in different depths at multiple sites and is also anti-infective. It is an ideal flap for repairing multi-site composite tissue defects of foot and ankle.
