Retalho sural estendido de pedículo distal

Vendramin, Fabiel Spani; Claudio-da-Silva, César

doi:10.1590/s0100-69912004000400007

Cited by 3 publications

(7 citation statements)

References 17 publications

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“…We cannot state that the proposed alterations such as main taining a fasciosubcutaneous margin that exceeds the skin flap and maintaining a lane of skin over the pedicle (group 2) are responsible for the improved results because the learning phase also influenced the results in group 1. However, these results reinforce the findings of previous studies, which show the importance of paying attention to technical details when preparing the flap 11,12 and avoiding the most common errors committed during the learning phase.…”

Section: Discussionsupporting

confidence: 91%

“…Articles and books describe the location of the medial sural nerve in the same plane as, but lateral to, the minor saphenous vein 1,2,5 . However, dissection of the higher margin of the flap occurs in the proximal third of the leg, and the saphenous vein may be located superfascially and the nerve may be subfascial in this region [11][12][13] . Thus, the surgeon may inadvertently take only the saphenous vein and several nearby nerves, lea ving the sural nerve out of the flap.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown good results with the use of this flap [4][5][6][7][8][9][10][11][12][13] . Because several errors are common during the learning phase of this technique, describing these errors may improve the initial results and may support the continued use of this flap.…”

Section: Introductionmentioning

confidence: 99%

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Retalho sural de fluxo reverso: 10 anos de experiência clínica e modificações

Vendramin¹

2012

Rev. Bras. Cir. Plást.

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Reverse flow sural flap: 10 years of clinical experience and changes Reverse-flow sural flap: 10 years of clinical experience and modifications Retalho sural de fluxo reverso: 10 anos de experiência clínica e modificações ABSTRACT Background: The reverse flow sural flap has been featured as a relevant option for reconstruction of the distal region of the legs and feet. However, some common mistakes are made while surgeons are learning how to employ this flap. The aim of this study was to analyze use of the flap by surgeons in with 10 years of experience by comparing the first 5 years to the last 5 years in order to identify technical alterations that contribute to better results. This study also aimed at alerting the surgeons in the learning phase regarding the most important details that should be addressed when using this technique. Methods: We studied the results obtained for 61 reverse flow sural flaps used from January 2002 to December 2011. The patients were divided into 2 groups: group 1, patients that underwent surgery from January 2002 to December 2006 and group 2, patients that underwent surgery from January 2007 to December 2011. In group 2, we made changes to the fasciocutaneous flaps that included dissection of a fasciosubcutaneous margin exceeding the cutaneous portion of the flap and preservation of a lane of skin over the pedicle. Results: In group 1, the incidences of partial necrosis and total necrosis were 18.5% and 3.7%, respectively, whereas group 2 had an 8.8% incidence of partial necrosis and no cases of total necrosis. Conclusions: The reverse flow sural flap is a good option for the treatment of the distal region of the legs and feet. Experience with this technique and the additional cautions described herein may contribute to even better results.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Retalho sural de fluxo reverso: 10 anos de experiência clínica e modificações

Vendramin¹

2012

Rev. Bras. Cir. Plást.

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“…The fasciocutaneous or fascial flaps of distal pedicle can be a good alternative to the distal regions, although this requires a good local circulation [2][3][4] . The microsurgical free flap has become a frequent indication.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

“…Despite the lack of vascularization as safe as with the soleus muscle flap with a proximal pedicle, the flap of this muscle with reverse pedicle can solve various situations 16 . For lower lesions, we may use the calf fascial-subcutaneous flap, since its retrograde vascularization is preserved 3 . The cross-leg flap may also be employed, but due to the inconveniences caused to the patient by prolonged immobilization and the uncomfortable rest position, we prefer not to indicate it.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Use of local muscle flaps to cover leg bone exposures

Dávila¹,

Franco

d'Avila

et al. 2014

Rev. Col. Bras. Cir.

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Objective: To evaluate the use of the medial gastrocnemius muscle and/or soleus muscle flaps as surgical treatment of the leg bone exposure.Methods: We retrospectively analyzed the medical records of patients undergoing transposition of the medial gastrocnemius and / or soleus for treating exposed bone in the leg, from January 1976 to July 2009, gathering information on epidemiological data, the etiology the lesion, the time between the initial injury and muscle transposition, the muscle used to cover the lesion, the healing evolution of the skin coverage and the function of the gastrocnemius-soleus unit.Results: 53 patients were operated, the ages varying between nine and 84 years (mean age 41); 42 were male and 11 female. The main initial injury was trauma (84.8%), consisting of tibia and / or fibula fracture. The most frequently used muscle was the soleus, in 40 cases (75.5%). The rank of 49 patients (92.5%) was excellent or good outcome, of three (5.6%) as regular and of one (1.9%) as unsatisfactory.Conclusion: the treatment of bone exposure with local muscle flaps (gastrocnemius and/or soleus) enables obtaining satisfactory results in covering of exposed structures, favoring local vascularization and improving the initial injury. It offers the advantage of providing a treatment in only one surgical procedure, an earlier recovery and reduced hospital stay.

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Reconstrução de membro inferior – retalho fasciocutâneo sural

et al. 2019

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Resumo Objetivo Avaliar o uso do retalho fasciocutâneo sural de fluxo reverso na cobertura de lesões no terço distal dos membros inferiores. Métodos Foram analisados 24 casos, 20 de origem traumática, três por lesões esportivas e um por ressecção de lesão tumoral. Resultados Dos 24 prontuários avaliados, 16 eram homens e oito mulheres. A idade variou de seis a 75 anos. A maioria dos pacientes evoluiu com cicatrização total do retalho (21). Houve apenas um caso de necrose total do retalho em paciente diabético insulinodependente e hipertenso, evoluiu para posterior amputação do membro. Em dois casos, houve necrose parcial com posterior cicatrização por segunda intenção, um desses pacientes era tabagista pesado. As complicações foram associadas às comorbidades e, ao contrário do evidenciado por outros estudos, não houve correlação com a curva de aprendizado. Também não houve correlação com o local ou o tamanho da lesão a ser coberta. Conclusão Tem-se como relevância clinica que a técnica de retalho fasciocutâneo sural de fluxo reverso usada obteve 87,5% de sucesso, é uma opção viável e eficaz no arsenal terapêutico das lesões complexas dos membros inferiores.

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Retalho sural estendido de pedículo distal

Cited by 3 publications

References 17 publications

Retalho sural de fluxo reverso: 10 anos de experiência clínica e modificações

Retalho sural de fluxo reverso: 10 anos de experiência clínica e modificações

Use of local muscle flaps to cover leg bone exposures

Reconstrução de membro inferior – retalho fasciocutâneo sural

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