Application of lateral circumflex femoral artery chimeric flap to repair complex wounds of foot and ankle_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JIN Wenhu , ZHANG Ziyang , WU Xiangkui , QUAN Hui , QI Jianping ,  WEI Zairong

Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563000, P.R.China;

Corresponding author：

WEI Zairong, Email: zairongwei@sina.com

Keywords：

Lateral circumflex femoral artery; free flap; chimeric flap; foot and ankle; wound repair

DOI：

10.7507/1002-1892.202102039

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of lateral circumflex femoral artery chimeric flap transplantation in repair of complex wounds of foot and ankle.Methods A retrospective study was conducted to analyze the clinical data of 20 patients with complex wounds of foot and ankle treated with lateral circumflex femoral artery chimeric flap between June 2017 and June 2020. There were 14 males and 6 females with an average age of 42.8 years (range, 21-65 years). Among them, 8 cases had dorsalis pedis tendon defect with or without bone exposure, 4 cases had partial or total Achilles tendon defect without bone exposure, and 8 cases had deep cavity and bone exposure. The wound area ranged from 10 cm×6 cm to 21 cm×11 cm. The time from injury to operation ranged from 6 to 22 days, with an average of 9.4 days. The lateral femoral circumflex artery flap was used in 6 cases with fascia lata flap, 6 cases with rectus femoris aponeurosis flap, and 8 cases with lateral femoral muscle flap. The flap area ranged from 12.0 cm×6.5 cm to 35.0 cm×7.5 cm. All flap donor sites were sutured directly. The survival, appearance, texture, sensation of the flap, and complications of the donor site were observed. The foot and ankle function was evaluated by Kofoed score.Results All patients were followed up 8-24 months (mean, 14.2 months). On the 3rd day after operation, 1 case had partial necrosis of 1 flap with fascia lata flap and healed after dressing change; 1 case of chimeric muscle flap developed venous crisis at 12 hours after operation; the chimeric flaps survived successfully in the other 18 patients and the wounds were primary healing. The color and texture of the flaps were good, the flaps recovered protective sensation. Only linear scar remained in the donor site of thigh. There was no sensory disturbance around the incision or walking disturbance. The Kofoed score of the foot and ankle function at last follow-up was 75-96, with an average of 89.8. Among them, 15 cases were excellent, 4 cases were good, and 1 case was qualified. The excellent and good rate was 95.0%.Conclusion The application of lateral circumflex femoral artery chimeric flap can accurately and stereoscopically repair the complex wounds of foot and ankle and achieve satisfactory effectiveness.

Citation： JIN Wenhu, ZHANG Ziyang, WU Xiangkui, QUAN Hui, QI Jianping, WEI Zairong. Application of lateral circumflex femoral artery chimeric flap to repair complex wounds of foot and ankle. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(7): 891-895. doi: 10.7507/1002-1892.202102039 Copy

1.	Abdelfattah U, Power HA, Song S, et al. Algorithm for free perforator flap selection in lower extremity reconstruction based on 563 cases. Plast Reconstr Surg, 2019, 144(5): 1202-1213.
2.	Silva AK, Humphries LS, Maldonado AA, et al. Chimeric vs composite flaps for mandible reconstruction. Head Neck, 2019, 41(6): 1597-1604.
3.	Franchi A, Häfeli M, Scaglioni MF, et al. The use of chimeric musculocutaneous posterior interosseous artery flaps for treatment of osteomyelitis and soft tissue defect in hand. Microsurgery, 2019, 39(5): 416-422.
4.	郭翱, 宋达疆, 郑良军, 等. 游离股前外侧嵌合股直肌肌腱皮瓣移植修复腕背部复合组织缺损. 中华显微外科杂志, 2018, 41(5): 454-458.
5.	Kofoed H, Sørensen TS. Ankle arthroplasty for rheumatoid arthritis and osteoarthritis: prospective long-term study of cemented replacements. J Bone Joint Surg (Br), 1998, 80(2): 328-332.
6.	唐举玉, 卿黎明, 吴攀峰, 等. 游离腹壁下动脉嵌合穿支皮瓣修复合并深部死腔的下肢皮肤软组织缺损. 中华整形外科杂志, 2015, 31(6): 425-428.
7.	王晨, 罗鹏飞, 何飞, 等. 神经松解肌腱移植术治疗上肢严重热压伤的疗效评价. 中华创伤杂志, 2020, 36(4): 347-352.
8.	Diniz P, Pacheco J, Flora M, et al. Clinical applications of allografts in foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc, 2019, 27(6): 1847-1872.
9.	陈黎明, 刘毅, 张诚, 等. 带肌瓣的嵌合穿支皮瓣修复合并深部死腔的难愈性创面. 中华整形外科杂志, 2020, 36(3): 279-283.
10.	Pourtaheri N, Wang D, Calva D, et al. Adipofascial flaps with acellular dermal matrix compared with myocutaneous flap reconstruction in lumbar myelomeningocele defects. J Craniofac Surg, 2018, 29(5): 1137-1142.
11.	徐承新, 刘毅, 陈黎明, 等. 臀部筋膜脂肪瓣修复坐骨结节和大转子复发性窦道型压疮. 中国修复重建外科杂志, 2020, 34(10): 1354-1355.
12.	Ipaktchi R, Boyce MK, Mett TR, et al. Reconstruction using the tensor fasciae latae muscle flap. Oper Orthop Traumatol, 2018, 30(4): 228-235.
13.	Tanaka K, Mii S, Ishida M, et al. Salvage of infected prosthetic grafts at the groin or thigh using muscle flap coverage. Ann Vasc Dis, 2020, 13(4): 404-409.
14.	周丕育, 杨绍浦, 李尚权, 等. 两种不同方式髂骨瓣游离移植在胫骨骨缺损修复中的应用. 中华整形外科杂志, 2019, 35(12): 1230-1233.
15.	Yu J, Luo Z, Wu P, et al. Novel design of the chimeric deep inferior epigastric artery perforator flap that provides for three-dimensional reconstruction of composite tissue defects of the heel in children. Orthop Surg, 2021, 13(1): 216-224.
16.	彭汉伟, 林建英, 郭海鹏, 等. 以旋髂深动脉为蒂的髂骨-腹内斜肌筋膜嵌合瓣修复下颌骨口腔黏膜复合缺损. 中国修复重建外科杂志, 2018, 32(12): 1567-1571.
17.	Ki SH, Ma SH, Sim SH, et al. Unplanned change from double free flap to a chimeric anterolateral thigh flap in recurrent laryngeal cancer. Arch Craniofac Surg, 2019, 20(6): 416-420.
18.	张世民, 王欣, 唐茂林, 等. 穿支皮瓣的争论与当前共识. 中华显微外科杂志, 2014, 37(1): 3-4.
19.	邓呈亮, 肖顺娥, 魏在荣. 旋股外侧动脉斜支作为股前外侧游离皮瓣优选血管蒂的可行性研究. 中华烧伤杂志, 2020, 36(7): 636.

1. Abdelfattah U, Power HA, Song S, et al. Algorithm for free perforator flap selection in lower extremity reconstruction based on 563 cases. Plast Reconstr Surg, 2019, 144(5): 1202-1213.
2. Silva AK, Humphries LS, Maldonado AA, et al. Chimeric vs composite flaps for mandible reconstruction. Head Neck, 2019, 41(6): 1597-1604.
3. Franchi A, Häfeli M, Scaglioni MF, et al. The use of chimeric musculocutaneous posterior interosseous artery flaps for treatment of osteomyelitis and soft tissue defect in hand. Microsurgery, 2019, 39(5): 416-422.
4. 郭翱, 宋达疆, 郑良军, 等. 游离股前外侧嵌合股直肌肌腱皮瓣移植修复腕背部复合组织缺损. 中华显微外科杂志, 2018, 41(5): 454-458.
5. Kofoed H, Sørensen TS. Ankle arthroplasty for rheumatoid arthritis and osteoarthritis: prospective long-term study of cemented replacements. J Bone Joint Surg (Br), 1998, 80(2): 328-332.
6. 唐举玉, 卿黎明, 吴攀峰, 等. 游离腹壁下动脉嵌合穿支皮瓣修复合并深部死腔的下肢皮肤软组织缺损. 中华整形外科杂志, 2015, 31(6): 425-428.
7. 王晨, 罗鹏飞, 何飞, 等. 神经松解肌腱移植术治疗上肢严重热压伤的疗效评价. 中华创伤杂志, 2020, 36(4): 347-352.
8. Diniz P, Pacheco J, Flora M, et al. Clinical applications of allografts in foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc, 2019, 27(6): 1847-1872.
9. 陈黎明, 刘毅, 张诚, 等. 带肌瓣的嵌合穿支皮瓣修复合并深部死腔的难愈性创面. 中华整形外科杂志, 2020, 36(3): 279-283.
10. Pourtaheri N, Wang D, Calva D, et al. Adipofascial flaps with acellular dermal matrix compared with myocutaneous flap reconstruction in lumbar myelomeningocele defects. J Craniofac Surg, 2018, 29(5): 1137-1142.
11. 徐承新, 刘毅, 陈黎明, 等. 臀部筋膜脂肪瓣修复坐骨结节和大转子复发性窦道型压疮. 中国修复重建外科杂志, 2020, 34(10): 1354-1355.
12. Ipaktchi R, Boyce MK, Mett TR, et al. Reconstruction using the tensor fasciae latae muscle flap. Oper Orthop Traumatol, 2018, 30(4): 228-235.
13. Tanaka K, Mii S, Ishida M, et al. Salvage of infected prosthetic grafts at the groin or thigh using muscle flap coverage. Ann Vasc Dis, 2020, 13(4): 404-409.
14. 周丕育, 杨绍浦, 李尚权, 等. 两种不同方式髂骨瓣游离移植在胫骨骨缺损修复中的应用. 中华整形外科杂志, 2019, 35(12): 1230-1233.
15. Yu J, Luo Z, Wu P, et al. Novel design of the chimeric deep inferior epigastric artery perforator flap that provides for three-dimensional reconstruction of composite tissue defects of the heel in children. Orthop Surg, 2021, 13(1): 216-224.
16. 彭汉伟, 林建英, 郭海鹏, 等. 以旋髂深动脉为蒂的髂骨-腹内斜肌筋膜嵌合瓣修复下颌骨口腔黏膜复合缺损. 中国修复重建外科杂志, 2018, 32(12): 1567-1571.
17. Ki SH, Ma SH, Sim SH, et al. Unplanned change from double free flap to a chimeric anterolateral thigh flap in recurrent laryngeal cancer. Arch Craniofac Surg, 2019, 20(6): 416-420.
18. 张世民, 王欣, 唐茂林, 等. 穿支皮瓣的争论与当前共识. 中华显微外科杂志, 2014, 37(1): 3-4.
19. 邓呈亮, 肖顺娥, 魏在荣. 旋股外侧动脉斜支作为股前外侧游离皮瓣优选血管蒂的可行性研究. 中华烧伤杂志, 2020, 36(7): 636.

Chinese Journal of Reparative and Reconstructive Surgery

Application of lateral circumflex femoral artery chimeric flap to repair complex wounds of foot and ankle

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content