Sagittal flaps in below-knee amputations in Chinese patients

Au, KK

doi:10.1302/0301-620x.71b4.2768305

Cited by 4 publications

(3 citation statements)

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“…The cross-section of the lower leg is normally not circular but wider anteroposteriorly than mediolaterally. From the perspective of the ratio of flap width to length, Au 6) indicated that the blood flow is more stable in flaps created medially and laterally than in those created anteriorly and posteriorly. Thus, in belowknee amputation, closure using medial and lateral flaps is more advantageous than that using anterior and posterior flaps because of its simpler, easier procedure and more stable blood flow.…”

Section: Discussionmentioning

confidence: 99%

Below-knee Amputation with Medial and Lateral Skin Flaps

Ihara

Toriumi

Matsuzaki

2020

International Journal of Surgical Wound Care

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Background: Progress in multidisciplinary therapy has led to a trend to avoid below-knee amputation for critical limb ischemia. However, there are still serious cases in which such amputation must be performed. In typical below-knee amputation cases, the surgical wound is most commonly closed using anterior and posterior skin flaps, but delayed healing is not unusual in critical limb ischemia cases. One cause for the delayed healing of wound margins is thought to be the difference in the length and thickness of the wound margins between the anterior and posterior skin flaps. Methods: Four critical limb ischemia patients who were receiving hemodialysis for diabetic renal failure were treated with below-knee amputation using medial and lateral skin flaps of similar lengths and thicknesses. Result: All patients achieved satisfactory healing by wound closure. Conclusions: In critical limb ischemia patients undergoing maintenance hemodialysis for diabetic renal failure, medial and lateral flaps may be a viable option in below-knee amputation provided the patients are not candidates for postoperative prosthesis, such as elderly patients with preoperative gait difficulty.

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Section: Discussionmentioning

confidence: 99%

Below-knee Amputation with Medial and Lateral Skin Flaps

Ihara

Toriumi

Matsuzaki

2020

International Journal of Surgical Wound Care

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“…These authors did not discuss the success of this technique in relation to the blood supply (see below). The technique described by Tracey 8 and refined by Au,9 utilises equal-sized sagittal flaps, which include fascia and muscle, on the medial and lateral sides of the calf. These flaps have a larger breadth:length ratio than the conventional posterior flap which is said to account for their superiority.…”

mentioning

confidence: 99%

“…The sagittal flap 8,9 is reported to yield better results because of the cross-sectional anatomy of the calf. Since the sagittal diameter is greater than the coronal diameter, sagittal flaps have a favourable breadth:length ratio.…”

mentioning

confidence: 99%