1.Pedicled bridge transplantation for soft tissue defects at the contrallateral leg with medial leg skin flap and medial hemi-soleus muscle flap
Gonglin ZHANG ; Fugui SHI ; Jun HU ; Tiejun GONG ; Yongheng WANG ; Laixu ZHAO ; Junlin YANG ; Jianhua ZHOU ; Qinyi XUE
Chinese Journal of Orthopaedic Trauma 2020;22(2):162-165
Objective:To evaluate the pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap for the treatment of soft tissue defects at the contrallateral leg.Methods:Between January of 2012 and January of 2016, 8 patients with soft tissue defects at the leg were treated at Department of Orthopedic Surgery, Hand and Foot Surgery Hospital of Lanzhou. They were 5 men and 3 women, aged from 19 to 50 years (mean, 35 years). All of them were treated by bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap pedicled with posterior tibial artery. The size of the defects ranged from 10 cm×9 cm to 13 cm×8 cm. The immediate coverage of the muscle flaps and vessel pedicle was repaired by a meshed split-thickness skin graft. The donor site was closed directly. The therapeutic efficacy was assessed at the final follow-up according to the criteria by Iowa for tibial fractures.Results:All the skin flaps and muscle flaps survived without any vascular crisis. One case developed necrosis of small skin graft at the distal muscle flap which spontaneously healed after dressing change for 2 weeks. Their follow-up ranged from 2.5 to 4.5 years (mean, 3.8 years). A good contour was confirmed at the recipient area. By the Iowa criteria at the final follow-up, 3 cases were excellent, 4 good and one fair.Conclusion:Pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap is a good treatment for soft tissue defects at the contrallateral leg which has only one major blood vessel, reducing damage to the donor site.
2.Repair of limb soft tissue defect with free deep inferior epigastric perforator flap
Gong-Lin ZHANG ; Ping ZHEN ; Ke-Ming CHEN ; Laixu ZHAO ; Jun-Lin YANG ; Jan-Hua ZHOU ; Qin-Yi XUE
China Journal of Orthopaedics and Traumatology 2014;(9):775-777
Objective:To report the clinical application results of free deep inferior epigastric perforator flap in the repair of soft tissue defect. Methods:From January 2006 to January 2012,13 patients with soft tissue defect(7 cases in leg and 6 cas-es in forearm) underwent reconstruction with a free deep inferior epigastric perforator flap. There were 9 males and 4 females , aged from 21 to 45 years old with an average of 33 years. Soft tissue defect in the extremities were from 7 cm×17 cm to 8 cm×26 cm. The medial branch and lateral brangh flaps were 7 cases and 6 cases respectively. The donor site was closed directly. Re-sults:One patient developed small wound dehiscence ,which spontaneous healed at one month after surgery. All the flaps had survived completely. Follow up period ranged from 1.8 to 4.0 years with the mean of 2.8 years postoperatively. Satisfactory clinical results were obtained in 12 cases. A good contour was confirmed at the recipient area. Conclusion:The free deep infe-rior epigastric perforator flap for the extremities defects of soft tissue is a good option. This technique is safe and reliable ,and can decrease the injury of donor site.