CLINICAL APPLICATION OF SURAL FASCIOMYOCUTANEOUS PERFORATOR FLAP IN REPAIR OF SOFT TISSUE DEFECT IN WEIGHT-BEARING AREA OF FOOT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LUShengdi ,  CHAIYimin

Department of Orthopedics, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P. R. China;

Corresponding author：

CHAIYimin, Email: chaiyimin@outlook.com

Keywords：

Compound tissue flap; Sural nerve; Weight-bearing area of heel; Wound repair

DOI：

10.7507/1002-1892.20140323

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To assess the effectiveness of the sural fasciomyocutaneous perforator flap in repair of soft tissue defect in weight-bearing area of the foot. Methods Between January 2007 and September 2010, 19 patients with soft tissue defects in the weight-bearing area of the foot were treated with sural fasciomyocutaneous perforator flaps. The etiology was traffic accident in 16 patients and crush injury in 3 patients. The interval of injury and admission was 2 hours to 14 days. The size of defect ranged from 8 cm×6 cm to 26 cm×16 cm; the size of flap ranged from 7 cm×7 cm to 25 cm×12 cm. The donor sites were repaired by free skin graft. The flap survival was observed after operation, and the pain score and sensory recovery at the reci pient site were used to assess the effectiveness. Results The flaps survived with satisfactory aesthetic and functional results in 18 cases. Partial flap necrosis was noted and second healing was achieved after spl it thickness skin grafting in 1 case. One case of delayed ulceration was also noted after 5 weeks, ulceration was successfully cured after wound care and avoidance of weightbearing for 2 weeks. All patients were followed up 9-25 months (mean, 14.1 months). The flaps had good appearance, without bulky pedicle. Superficial sensation and deep sensation were restored in 17 cases (89.4%) and 18 cases (94.7%) respectively at last follow-up. Conclusion Sural fasciomyocutaneous perforator flap is a rel iable modality in heel reconstruction, having the advantages of low ulceration rate, good wear resistance, and good sensation recovery.

Citation： LUShengdi, CHAIYimin. CLINICAL APPLICATION OF SURAL FASCIOMYOCUTANEOUS PERFORATOR FLAP IN REPAIR OF SOFT TISSUE DEFECT IN WEIGHT-BEARING AREA OF FOOT. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(12): 1494-1497. doi: 10.7507/1002-1892.20140323 Copy

1.	Shaw WW, Hidalgo DA. Anatomic basis of plantarflap design:cl inical applications. Plast Reconstr Surg, 1986, 78(5):637-649.
2.	Hollenbeck ST. Longitudinal outcomes and application of the subunit princi ple to 165 foot and ankle free tissue transfers. Plast Reconstr Surg, 2010, 125(3):924-934.
3.	May JW Jr, Halls MJ, Simon SR. Free microvascular muscle flaps with skin graft reconstruction of extensive defects of the foot:a cl inical and gait analysis study. Plast Reconstr Surg, 1985, 75(5):627-641.
4.	Sönmez A, BayramiçliM, Sönmez B, et al. Reconstruction of the weight-bearing surface of the foot with nonneurosensory free flaps. Plast Reconstr Surg, 2003, 111(7):2230-2236.
5.	Hong JP, Kim EK. Sole reconstruction using anterolateral thigh perforator free flaps. Plast Reconstr Surg, 2007, 119(1):186-193.
6.	Ohjimi H, Taniguchi Y, Kawano K, et al. A comparison of thinning and conventional free-flap transfers to the lower extremity. Plast Reconstr Surg, 2000, 105(2):558-566.
7.	Masquelet AC, Romana MC, Wolf G. Skin island flaps suppl ied by the vascular axis of the sensitive superficial nerve:Anatomic study and cl inical experience in the leg. Plast Reconstr Surg, 1992, 89(6):1115-1121.
8.	Weinzweig N, Davies BW. Foot and ankle reconstruction using the radial forearm flap:A review of 25 cases. Plast Reconstr Surg, 1998, 102(6):1999-2005.
9.	Song YG, Chen GZ, Song YL. The free thigh flap:a new free flap concept based on the septocutaneous artery. Br J Plast Surg, 1984, 37(2): 149-159.
10.	Nakajima H, Imanishi N, Fukuzumi S, et al. Accompanying arteries of the lesser asphenous vein and sural nerve:Anatomic study and its cl inical applications. Plast Reconstr Surg, 1999, 103(1):104-120.
11.	Hallock GG. Distally based flaps for skin coverage of the foot and ankle. Foot Ankle Intl, 1996, 17(6):343-348.
12.	Chai Y, Zeng B, Zhang F, et al. Experience with the distally based sural neurofasciocutaneous flap supplied by the terminal perforator of peroneal vessels for ankle and foot reconstruction. Ann Plast Surg, 2007, 59(5):526-531.
13.	Follmar KE, Baccarani A, Baumeister SP, et al. The distally based sural flap. Plast Reconstr Surg, 2007, 119(6):138e-148e.
14.	Al-Qattan MM. The reverse sural artery adi pofasciomuscular flap for the reconstruction of a heel sinus with underlying calcaneal osteomyel itis. Ann Plast Surg, 2007, 58(6):688-690.
15.	Le Fourn B, Caye N, Pannier M. Distally based sural fasciomuscular flap:Anatomic study and appl ication for fill ing leg or foot defects. Plast Reconstr Surg, 2001, 107(1):67-72.
16.	Durham JW, Saltzman CL, Steyers CM, et al. Outcome after free flap reconstruction of the heel. Foot Ankle Int, 1994, 15(5):250-255.
17.	Noever G, Brüser P, Köhler L. Reconstruction of heel and sole defects by free flaps. Plast Reconstr Surg, 1986, 78(3):345-352.
18.	Mueller JE, Ilchmann T, Lowatscheff T. The musculocutaneous sural artery flap for soft-tissue coverage after calcaneal fracture. Arch Orthop Trauma Surg, 2001, 121(6):350-352.

1. Shaw WW, Hidalgo DA. Anatomic basis of plantarflap design:cl inical applications. Plast Reconstr Surg, 1986, 78(5):637-649.
2. Hollenbeck ST. Longitudinal outcomes and application of the subunit princi ple to 165 foot and ankle free tissue transfers. Plast Reconstr Surg, 2010, 125(3):924-934.
3. May JW Jr, Halls MJ, Simon SR. Free microvascular muscle flaps with skin graft reconstruction of extensive defects of the foot:a cl inical and gait analysis study. Plast Reconstr Surg, 1985, 75(5):627-641.
4. Sönmez A, BayramiçliM, Sönmez B, et al. Reconstruction of the weight-bearing surface of the foot with nonneurosensory free flaps. Plast Reconstr Surg, 2003, 111(7):2230-2236.
5. Hong JP, Kim EK. Sole reconstruction using anterolateral thigh perforator free flaps. Plast Reconstr Surg, 2007, 119(1):186-193.
6. Ohjimi H, Taniguchi Y, Kawano K, et al. A comparison of thinning and conventional free-flap transfers to the lower extremity. Plast Reconstr Surg, 2000, 105(2):558-566.
7. Masquelet AC, Romana MC, Wolf G. Skin island flaps suppl ied by the vascular axis of the sensitive superficial nerve:Anatomic study and cl inical experience in the leg. Plast Reconstr Surg, 1992, 89(6):1115-1121.
8. Weinzweig N, Davies BW. Foot and ankle reconstruction using the radial forearm flap:A review of 25 cases. Plast Reconstr Surg, 1998, 102(6):1999-2005.
9. Song YG, Chen GZ, Song YL. The free thigh flap:a new free flap concept based on the septocutaneous artery. Br J Plast Surg, 1984, 37(2): 149-159.
10. Nakajima H, Imanishi N, Fukuzumi S, et al. Accompanying arteries of the lesser asphenous vein and sural nerve:Anatomic study and its cl inical applications. Plast Reconstr Surg, 1999, 103(1):104-120.
11. Hallock GG. Distally based flaps for skin coverage of the foot and ankle. Foot Ankle Intl, 1996, 17(6):343-348.
12. Chai Y, Zeng B, Zhang F, et al. Experience with the distally based sural neurofasciocutaneous flap supplied by the terminal perforator of peroneal vessels for ankle and foot reconstruction. Ann Plast Surg, 2007, 59(5):526-531.
13. Follmar KE, Baccarani A, Baumeister SP, et al. The distally based sural flap. Plast Reconstr Surg, 2007, 119(6):138e-148e.
14. Al-Qattan MM. The reverse sural artery adi pofasciomuscular flap for the reconstruction of a heel sinus with underlying calcaneal osteomyel itis. Ann Plast Surg, 2007, 58(6):688-690.
15. Le Fourn B, Caye N, Pannier M. Distally based sural fasciomuscular flap:Anatomic study and appl ication for fill ing leg or foot defects. Plast Reconstr Surg, 2001, 107(1):67-72.
16. Durham JW, Saltzman CL, Steyers CM, et al. Outcome after free flap reconstruction of the heel. Foot Ankle Int, 1994, 15(5):250-255.
17. Noever G, Brüser P, Köhler L. Reconstruction of heel and sole defects by free flaps. Plast Reconstr Surg, 1986, 78(3):345-352.
18. Mueller JE, Ilchmann T, Lowatscheff T. The musculocutaneous sural artery flap for soft-tissue coverage after calcaneal fracture. Arch Orthop Trauma Surg, 2001, 121(6):350-352.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF SURAL FASCIOMYOCUTANEOUS PERFORATOR FLAP IN REPAIR OF SOFT TISSUE DEFECT IN WEIGHT-BEARING AREA OF FOOT

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content