Clinical aspects of reconstruction of the lower third of the leg with fasciocutaneous flap based on peroneal artery perforators

Terzić, Zoran; Djordjevic, Boban

doi:10.2298/vsp1401039t

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons, especially in patients with underlying vascular disease, which can induce circulation problems, and in patients with chronic wounds induced by severe trauma. Various options have been reported in the literature for the coverage of soft tissue defects of the ankle and heel [ 1 2 3 ]. Utilizing local flaps with random vascularity can provide a simple way to cover soft tissue defects; however, this technique is restricted by the limited amount of tissue that can be moved from the donor site to the defect area [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The peroneal artery perforator-based pedicled flap was originally introduced by Koshima et al [ 10 ] in Japan in 1992. It was introduced as an alternative to distally-based sural neurocutaneous flaps in ankle and heel reconstructions [ 3 10 11 12 ]. The anatomy of the peroneal artery perforator has been widely researched and found to be primarily useful for the reconstruction of ankle and heel defects.…”

Section: Introductionmentioning

confidence: 99%

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Reconstruction of Ankle and Heel Defects with Peroneal Artery Perforator-Based Pedicled Flaps

et al. 2015

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Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions.MethodsFrom July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review.ResultsThe mean age of the patients was 52.4 years. The size of the flaps ranged from 5×4 to 20×8 cm2. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities.ConclusionsPeroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reconstruction of Ankle and Heel Defects with Peroneal Artery Perforator-Based Pedicled Flaps

et al. 2015

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“…The methods of reconstruction of the lower leg and foot with fasciocutaneous locoregional flaps have been constantly improving and evolving over the recent years. Perforator style flaps and their modification such as propeller flaps, are essentially distally based flaps whose perfusion is ensured by a single perforator with sufficient calibre from the peroneal or tibial posterior artery [35][36][37][38] . Pedicle circulation is based on the same principles as in NF through the vascular chain surrounding the saphenous or sural nerve.…”

Section: Discussionmentioning

confidence: 99%

Neurocutaneous flaps for soft tissue reconstruction of the knee, lower leg, ankle and foot: Clinical experience with 32 patients

et al. 2019

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Background/Aim. Neurocutaneous flaps (NF) are the type of fasciocutaneous flaps whose clinical application has increasingly grown over the years. They have become an indispensable step in the reconstructive ladder for the small and medium soft tissue defects of the lower leg and foot. The aim of this study was to analyse the results of the treatment of patients with lower extremity soft tissue defects caused by trauma, infection, tumour removal or unstable scar formation, which were reconstructed with a variety of NF. Methods. This retrospective study includes 32 consecutive patients with soft tissue defects of the lower limb, treated in the Clinical Centre of Vojvodina from January 2004 to April 2017. All the operations were performed in regional anaesthesia with pneumatic tourniquet. Design of the flap and length of the pedicle were determined by the size and position of the recipient site after necessary debridement. The flap was harvested, rotated and positioned in the defect region. The patients and flap data were summarized upon their collection. Results. The average age of the patients, mostly males (81.2%), was 46.7 years. Distally based sural flaps were used in a majority of patients (56.2%), followed by the distally based saphenous (21.9%), lateral sural (12.5%) and proximally based sural flaps (9.4%). Defects were most often localized on the distal third of the lower leg and on the ankle (53.1%). The most common indication for surgery were trauma (46.9%) and chronic infection (31.2%). A satisfactory coverage of the defect was achieved in all 32 patients with no flap loss. A partial necrosis of the flap due to prolonged venous congestion was noted in 3 (9.4%) patients, which were healed by second intention or with delayed skin grafting. Five (15.6%) patients developed a localised infection. The infection signs withdrew spontaneously in 2 cases and after a surgical revision in 3 cases, where osteitis of the tibia had persisted. One of them required the Ilizarov orthopaedic procedure after bone resection. Conclusion. NF proved to be a paramount alternative to free-flap reconstruction of the lower limb. Intensive clinical application can be explained by the fact that it is a less technically demanding and time consuming surgical procedure with no major source vessel sacrifice. The reliability and safety of their utilisation are confirmed by our clinical data.

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Reconstrução do membro inferior com retalho fasciocutâneo de pedículo distal - Técnica de Monteiro modificada, série de 15 casos

Montenegro

Costa

Meves

2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Descrever e demonstrar o desfecho da técnica modificada de Monteiro (1991) para a reconstrução do membro inferior com retalho fasciocutâneo de pedículo distal numa série de 15 casos. Método Com uma série de 15 casos, apresentamos a técnica e o desfecho da técnica modificada do retalho fasciocutâneo de pedículo distal com para a reparação do terço inferior da perna e do pé. Resultados Os resultados foram satisfatórios porque os retalhos proporcionaram boa cobertura de pele e tecido celular subcutâneo nos casos de exposição óssea e perda cutânea. A área doadora foi fechada 3 dias após a cirurgia, com enxerto de pele de espessura parcial, proporcionando uma melhor viabilidade do enxerto. Conclusão O retalho fasciocutâneo de pedículo distal mostrou-se como uma boa opção para a reconstrução do terço médio e inferior da perna, oferecendo boa cobertura óssea.

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Clinical aspects of reconstruction of the lower third of the leg with fasciocutaneous flap based on peroneal artery perforators

Cited by 3 publications

References 22 publications

Reconstruction of Ankle and Heel Defects with Peroneal Artery Perforator-Based Pedicled Flaps

Reconstruction of Ankle and Heel Defects with Peroneal Artery Perforator-Based Pedicled Flaps

Neurocutaneous flaps for soft tissue reconstruction of the knee, lower leg, ankle and foot: Clinical experience with 32 patients

Reconstrução do membro inferior com retalho fasciocutâneo de pedículo distal - Técnica de Monteiro modificada, série de 15 casos

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