Continuous transfer for repairing soft tissue defects of the foot and ankle by sural neurovascular flap and free-style perforator flap [腓肠神经营养血管皮瓣及小腿近端自由设计穿支皮瓣连续转移修复足踝部软组织缺损]

作者：Zonghui G.; Yin T.; Junjie W.; Youwei F.; Changchun Y.; Qingjiang P.^*

来源：Chinese Journal of Plastic Surgery, 2021, 37(10): 1152-1157.

DOI：10.3760/cma.j.cn114453-20200708-00412

• Ankle
• Foot
• Perforator flap
• Reconstructive surgical procedures
• Sural neurovascular flap

Objective To explore the clinical effect of continuous transfer of sural neurovascular flap and free-style perforator flap for repairing soft tissue defect of foot and ankle. Methods Clinical data of patients with skin and soft tissue defects of the foot and ankle from Ningbo HwaMei Hospital, University of Chinese Academy of Sciences were enrolled in this study from February 2011 to February 2020. The sural neurovascular flap was used to repair the soft tissue defect of the ankle and foot, and the free-style perforator flap was designed to cover the donor site in the proximal lower leg. The survival of the flaps in the recipient and donor sites were observed after surgery, and the morphology, sensation, and foot and ankle movement were followed up in the later period. Results A total of 11 patients with soft tissue defects in the ankle and foot were enrolled, including 7 males and 4 females, average aged 41±3 years old. The area of the wound defect was 3. 0 cm×5. 0 cm-7. 0 cm×10. 0 cm; the size of sural neurovascular flap was 4. 0 cm ×10. 0 cm-9. 0 cm×17. 0 cm; and the size of perforator flap of the proximal lower leg was 4. 5 cm×6. 5 cm -5. 5 cm×10. 5 cm on average, respectively. All flaps were survived primarily without infection, vascular crisis, and flap necrosis. Patients were followed up for 2-36 months in this study, with an average of 10. 2 months. There was no scar contracture being observed, and the shape and sensation of the flap of patients were recovered well. Two-point distance discrimination of the flap of ankle and foot was 13-18 mm. The angle of ankle dorsiflexion, plantar flexion, inversion, and eversion were 30°-45°, 35°-45°, 30°-40°, respectively. Conclusions We found that the wound of the foot and ankle could be safely and effectively repaired by the sural neurovascular flap, and the donor site on the proximal lower leg could be well repaired by free-style perforator flaps, with no sacrifice with the main blood vessel. Overall, these two methods can not only obtain a good appearance but also reduce functional damage.

• 单位
  中国科学院大学