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 ◽  
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 ◽  
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.

Distally Based Sural Fasciocutaneous Flaps for Reconstructing Soft Tissue Defects Proximal and Distal to the Tarsometatarsal Joints: A Comparative Analysis

2021 ◽  
pp. 153473462110023
Author(s):  
Zhaobiao Luo ◽  
Jiangdong Ni ◽  
Guohua Lv ◽  
Jianwei Wei ◽  
Lihong Liu ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Soft Tissue ◽  
Clinical Outcomes ◽  
Salvage Treatment ◽  
Soft Tissue Defects ◽  
Fasciocutaneous Flaps ◽  
Partial Necrosis ◽  
Number Of Patients ◽  
Distally Based ◽  
Tissue Defects

Distally based sural fasciocutaneous (DBSF) flaps are widely used for reconstructing soft tissue defects of the foot. The purpose of this paper was to compare the clinical efficacy of the use of flaps to repair defects in areas proximal and distal to the level of the tarsometatarsal joints in a relatively large number of patients and to analyze the effects of factors on the risk of developing partial necrosis of the flaps. Between April 2001 and December 2019, a total of 355 DBSF flaps were utilized to cover soft tissue defects in the foot. According to the furthest location of the defects reconstructed with the flaps, the flaps were divided into the proximal foot group (n = 260) and the distal foot group (n = 95). The partial necrosis rates, their influencing factors, and the clinical outcomes of the procedure were compared between the two groups. In the proximal foot group, the partial necrosis rate (6.2%, 16 of 260) was significantly lower than that in the distal foot group (14.7%, 14 of 95) ( P < .05). The proportion of successful coverage of the defects using the flaps alone or in combination with a simple salvage treatment was comparable between the groups ( P > .05). The ratio of unfavorable conditions in the distal foot group was higher than that in the proximal foot group ( P < .05). DBSF flaps can be effectively utilized to repair defects in the proximal and distal areas of the foot. The use of a DBSF flap to repair defects in the proximal areas of the foot is superior to the use of DBSF flaps for repairing defects in the distal areas of the foot in terms of reliable survival of the flap.

scholarly journals Free Peroneal Artery Perforator-Based Flap for Soft Tissue Reconstruction of the Finger

2017 ◽  
Vol 02 (02) ◽  
pp. e136-e139
Author(s):  
Kenji Kawamura ◽  
Hiroshi Yajima ◽  
Shohei Omokawa ◽  
Takamasa Shimizu ◽  
Satoshi Hayashi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Peroneal Artery ◽  
Soft Tissue Reconstruction ◽  
Digital Artery ◽  
Soft Tissue Defects ◽  
Tissue Reconstruction ◽  
Perforator Vessels ◽  
Artery Perforator ◽  
Tissue Defects

Background The peroneal artery perforator-based flap has been widely used as a pedicled propeller flap for soft tissue reconstruction in the lower extremity; however, its application as a free flap has been rarely reported. We report on the utility of the free peroneal artery perforator-based flap for finger soft tissue reconstruction. Methods Twelve patients underwent reconstructions of soft tissue defects of the finger with free peroneal artery perforator-based flaps. The soft tissue defects were located either dorsally and/or laterally on the fingers. The size of the flaps ranged from 5 × 2 to 8 × 3 cm. The length of the vascular pedicles ranged from 4 to 5 cm. The artery and vein of the perforator vessels were anastomosed in the finger to the digital artery and subcutaneous vein, respectively. Results All twelve flaps survived completely, and the donor site in the lower leg was closed primarily in all cases. Secondary defatting was performed in six cases, while in the remaining cases, thinning of the flap was performed when the flap was transferred. Conclusion The advantages of the free peroneal artery perforator-based flap for finger soft tissue reconstruction include the following: the flap is flexible and can be thinned to match the texture of the finger; elevation of the flap is easy; the donor site can be closed primarily; there is no need to sacrifice any main arteries in the lower leg; and the diameter of the perforator vessels is suitable for anastomosis to the digital artery and subcutaneous vein in the finger.

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