Reconstruction of soft tissue defects around the Achilles region with distally based extended peroneal artery perforator flap

Injury ◽  
2021 ◽  
Author(s):  
Altug Altinkaya ◽  
Sukru Yazar ◽  
Fuat Baris Bengur
Keyword(s):  
Soft Tissue ◽  
Perforator Flap ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Distally Based ◽  
Artery Perforator ◽  
Tissue Defects

scholarly journals Distally based peroneal artery perforator-plus fasciocutaneous flap in the reconstruction of soft tissue defects over the distal forefoot: a retrospectively analyzed clinical trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Ping Peng ◽  
Zhaobiao Luo ◽  
Guohua Lv ◽  
Jiangdong Ni ◽  
Jianwei Wei ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Kirschner Wire ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Partial Necrosis ◽  
Total Length ◽  
Distally Based ◽  
Artery Perforator ◽  
Pedicle Width ◽  
Tissue Defects

Abstract Background Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps are widely used for reconstructing soft-tissue defects of the lower extremity. However, reports on the reconstruction of the defects over the distal forefoot using the DPAPF flaps are scarce. Herein, we describe our experience on the reconstruction of these defects using DPAPF flaps in a considerable sample size. Methods Between February 2005 and August 2019, a total of 56 DPAPF flaps in 56 patients were used to reconstruct soft-tissue defects in the forefoot. In order to reduce the length of fascial pedicle and the total length of the DPAPF flaps, the ankles were fixed in dorsiflexion using a Kirschner wire before designing the flaps. The flaps were elevated by the anterograde–retrograde approach. Patient factors and flap factors were compared between the “survival” and “partial necrosis” groups. Results Overall, 47 flaps had survived completely in one stage. Partial necrosis developed in nine flaps, with only one remnant defect covered using a local flap. By fixing the ankles in dorsiflexion, the length of the fascial pedicle was reduced approximately 2.35 ± 0.58 cm, the total length of the flap was simultaneously shortened by the same amount as the length of the fascial pedicle. The width of the fascia pedicle varied from 3.0 cm to 6.0 cm. The fascial pedicle width > 4 cm was found in 21 flaps. The partial necrosis rate of the DPAPF flaps with the top edge located in the 8th zone was significantly lower than that in the 9th zone (p < 0.05). Conclusions The DPAPF flaps can be effectively used to reconstruct the defects over the distal forefoot because of convenient harvest and reliability. By fixing the ankle in dorsiflexion with Kirschner wire and widening the fascial pedicle appropriately, the top edge and LWR of the flaps will be decreased, and thus the procedures are helpful for the flaps survival.

scholarly journals Distally based peroneal artery perforator-plus fasciocutaneous flap in the reconstruction of soft tissue defects over the distal forefoot: a retrospectively analyzed clinical trial

2020 ◽  
Author(s):  
Ping Peng ◽  
Zhaobiao Luo ◽  
Guohua Lv ◽  
Jiangdong Ni ◽  
Jianwei Wei ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Kirschner Wire ◽  
Fasciocutaneous Flap ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Patient Factors ◽  
Partial Necrosis ◽  
Distally Based ◽  
Artery Perforator ◽  
Tissue Defects

Abstract Background: Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps are widely used for reconstructing soft-tissue defects of the lower extremity. However, large studies on this topic, especially DPAPF flaps use for reconstruction of defects over the distal forefoot, are scarce. Herein, we describe our experience on the reconstruction of defects over the distal forefoot using DPAPF flaps.Methods: Between February 2005 and August 2019, 56 DPAPF flaps were used to reconstruct soft-tissue defects in the forefoot. The ankles were fixed in dorsiflexion using a Kirschner wire. Patient factors and flap factors were compared between the “survival” and “partial necrosis” groups.Results: Overall, 47 flaps had survived completely in one stage. Partial necrosis developed in nine flaps, with only one remnant defect covered using a local flap. The distance between the pivot point and recipient area was reduced by fixing the ankles in dorsiflexion. The partial necrosis rate of the DPAPF flaps with the top edge located in the 8th zone was significantly lower than that in the 9th zone (p < 0.05).Conclusions: In combination with fixing of the ankles in dorsiflexion using a Kirschner wire, DPAPF flap is a good option in reconstructing a defect over the distal forefoot.

scholarly journals Distally based peroneal artery perforator-plus fasciocutaneous flap in the reconstruction of soft tissue defects over the distal forefoot: a retrospectively analyzed clinical trial

2020 ◽  
Author(s):  
Ping Peng ◽  
Zhaobiao Luo ◽  
Guohua Lv ◽  
Jiangdong Ni ◽  
Jianwei Wei ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Kirschner Wire ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Partial Necrosis ◽  
Total Length ◽  
Distally Based ◽  
Artery Perforator ◽  
Pedicle Width ◽  
Tissue Defects

Abstract Background Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps are widely used for reconstructing soft-tissue defects of the lower extremity. However, reports on the reconstruction of the defects over the distal forefoot using the DPAPF flaps are scarce. Herein, we describe our experience on the reconstruction of these defects using DPAPF flaps in a considerable sample size. Methods Between February 2005 and August 2019, a total of 56 DPAPF flaps in 56 patients were used to reconstruct soft-tissue defects in the forefoot. In order to reduce the length of fascial pedicle and the total length of the DPAPF flaps, the ankles were fixed in dorsiflexion using a Kirschner wire before designing the flaps. The flaps were elevated by the anterograde–retrograde approach. Patient factors and flap factors were compared between the “survival” and “partial necrosis” groups. Results Overall, 47 flaps had survived completely in one stage. Partial necrosis developed in nine flaps, with only one remnant defect covered using a local flap. By fixing the ankles in dorsiflexion, the length of the fascial pedicle was reduced approximately 2.35 ± 0.58 cm, the total length of the flap was simultaneously shortened by the same amount as the length of the fascial pedicle. The width of the fascia pedicle varied from 3.0 cm to 6.0 cm. The fascial pedicle width > 4 cm was found in 21 flaps. The partial necrosis rate of the DPAPF flaps with the top-edge located in the 8th zone was significantly lower than that in the 9th zone (p < 0.05).Conclusions The DPAPF flaps can be effectively used to reconstruct the defects over the distal forefoot because of convenient harvest and reliability. By fixing ankle in dorsiflexion with Kirschner wire and widening the fascial pedicle appropriately, the top-edge and LWR of the flaps will be decreased, and thus the procedures are helpful for the flaps survival.

Distally Based Peroneal Artery Perforator-Plus Fasciocutaneous Flap to Reconstruct Soft Tissue Defect Combined With Chronic Osteomyelitis in the Lateral Malleolus

2020 ◽  
pp. 153473462095678
Author(s):  
Zhaobiao Luo ◽  
Zhonggen Dong ◽  
Jiangdong Ni ◽  
Jianwei Wei ◽  
Ping Peng ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Chronic Osteomyelitis ◽  
Soft Tissue Defect ◽  
Lateral Malleolus ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Distally Based ◽  
Artery Perforator ◽  
Tissue Defects

Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps are widely used to reconstruct soft tissue defects of the lower extremity. Treatment for soft tissue defect combined with chronic osteomyelitis in the lateral malleolus has rarely been reported. The aim of this study was to elaborate the superiority of the DPAPF flap and provide referential experience for using the DPAPF flap in this situation. Between June 2010 and December 2017, soft tissue defects in the setting of chronic osteomyelitis in the lateral malleolus were reconstructed with DPAPF flaps in 17 patients. After thorough debridement, the defect was repaired with the DPAPF flap, and patients subsequently followed an antibiotic regimen for 6 weeks. Follow-up periods for all patients were at least 24 months. The reconstruction outcomes and the satisfaction of the 17 patients were evaluated. Of the 17 flaps, 16 survived uneventfully, except one occurrence of partial necrosis. No infection occurred in the follow-up period. In the study, 17 patients except one were satisfied with flap appearance. All the patients were satisfied with the reconstruction outcomes. In a one-stage procedure, the use of DPAPF flaps is ideal for reconstructing soft tissue defects in the setting of chronic osteomyelitis in the lateral malleolus.

The Effect of Medial Sural Artery Perforator Flap on Reconstruction of Soft Tissue Defects

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Qiang Xu ◽  
Shou-Cheng Yin ◽  
Xing-Zhou Su ◽  
Si-Min Wang ◽  
Yi-Hao Liu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Perforator Flap ◽  
Soft Tissue Defects ◽  
Sural Artery ◽  
Artery Perforator ◽  
Tissue Defects

scholarly journals Propeller perforator flaps from the dorsal digital artery perforator chain for repairing soft tissue defects of the finger

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Haoliang Hu ◽  
Hong Chen ◽  
Jinjiong Hong ◽  
Weisheng Mao ◽  
Mintao Tian ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Perforator Flap ◽  
Width Ratio ◽  
Digital Artery ◽  
Soft Tissue Defects ◽  
Clinical Trial Registry ◽  
Perforator Flaps ◽  
And Function ◽  
Artery Perforator ◽  
Tissue Defects

Abstract Background When restoring the appearance and function of the fingers, hand surgeons face a challenge in choosing a suitable surgical method to repair finger skin defects. Methods In this study, we designed a long elliptical flap based on a propeller perforator flap and located slightly toward the dorsal lateral aspect of the finger. The flap with a pedicle consisting of the dorsal perforator of the distal digital artery and dorsal digital artery perforator chain is rotated to cover a large wound on the distal end. From December 2014 to December 2017, 10 patients with finger soft tissue defects were treated with the propeller perforator flap described in this study. Results All flaps survived after surgery, and 2 had a transient venous congestion. After a follow-up period of 3 to 12 months, the static two-point discrimination of the flap was 8.06 ± 1.75 mm, and the range of motion was 149.4 ± 12.9°. This designed flap can span several angiosomes supplied by the perforators. Due to the inclusion of a vessel chain between the dorsal digital artery perforators, the length-to-width ratio of the flap can be up to 3:1. Conclusions This technique increases the size of flap that can be harvested safely while retaining a reliable blood supply. The present study describes a new method for repairing soft tissue defects of the finger by using the technique of propeller perforator flaps based on dorsal digital artery perforator chains. Trial registration The registration number of this study is ChiCTR1800014588; it has been retrospectively registered with Chinese Clinical Trial Registry (chictr.org.cn), 18/11/2019.

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