scholarly journals Distally Based Sural Faciocutaneous and Fascial (Adipofascial) Flap for Reconstruction of Distal Leg, Ankle and Foot Defects

2015 ◽  
Vol 12 (2) ◽  
pp. 126-131 ◽  
Author(s):  
NP Parajuli ◽  
D Shrestha ◽  
N Panse
Keyword(s):  
Soft Tissue ◽  
Secondary Infection ◽  
Soft Tissue Defect ◽  
Soft Tissue Reconstruction ◽  
Sural Flap ◽  
Hind Foot ◽  
Sural Artery ◽  
Distally Based ◽  
Distally Based Sural Flap ◽  
Ankle And Foot

Background Any soft tissue defect in distal leg, ankle and hind foot is still a challenging problem. There are various options for coverage of such defects, but the distally based sural neurocutaneous and neurofascial flap based on the sural nerve and superficial sural artery has been an important option.Objective To evaluate the efficacy of distally based sural flap in reconstruction of the distal leg, ankle and hind foot soft tissue defects.Method Seventeen patients with soft tissue defects over distal leg, ankle and hind foot were included in this study. All patients were treated with distally based sural flap. Most of the cases were due to trauma (16 cases) which compromised tendon and bone. One case was of malignant melanoma of sole of hind foot which required wide excision and soft tissue reconstruction with sural flap.Result In all cases defects were successfully covered. Three showed venous congestion and partial necrosis. One developed secondary infection. One flap failed completely. Mean follow up of patients was 20 months (6 – 36 months).Conclusion Sural flap is a good option for reconstruction of distal leg, ankle and foot defects.Kathmandu University Medical Journal Vol.12(2) 2014: 126-131

An Effective Technique for Managing the Calcaneus Osteomyelitis Combined with Soft-Tissue Defect

2021 ◽  
pp. 153473462110166
Author(s):  
Ping Peng ◽  
Zhong-Gen Dong ◽  
Lihong Liu ◽  
Jian-Wei Wei ◽  
Zhaobiao Luo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Soft Tissue Defect ◽  
Effective Technique ◽  
Sural Flap ◽  
Tissue Defect ◽  
Type Iii ◽  
Distally Based ◽  
Distally Based Sural Flap

The treatment of the Cierny–Mader (C–M) type III–IV calcaneus osteomyelitis combining with the soft-tissue defect is sophisticated and difficult. The aim of this study is to introduce the application and availability of the modified distally based sural flap with an adipofascial extension to reconstruct these defects. We retrospectively reviewed the data of 37 patients with C–M type III–IV calcaneus osteomyelitis accompanied with soft-tissue defect between December 2004 and December 2019. A modified distally based sural flap with an adipofascial extension was conducted to reconstruct the defect. The patient's demographics, duration of the diseases, etiology, reconstruction outcomes, infection control rate, recurrence rate, amputation rate, and follow-up data were collected to evaluate the effectiveness and reliability of the modification. The American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot scale was applied to assess the function of the ankle and hindfoot. Thirty-four flaps survived uneventfully, 1 flap displayed marginal necrosis and 2 flaps (5.41%) developed partial necrosis. Using this modified flap alone or combining with some simple salvage methods reconstructed all of the defects successfully. The calcaneus osteomyelitis was cured successfully, and no recurrences were observed during the follow-up period. The AOFAS ankle and hindfoot scores were excellent in 27 patients and good in 8 patients. The distally based sural flap with an adipofacial extension is a simple and effective technique to reconstruct the calcaneus osteomyelitis combined with soft-tissue defect in 1 stage. Applications of the adipofacial extension to obliterate the dead space and the well-vascularized skin island to cover the defect are the guarantee of achieving good ankle and foot functions. However, this technique is not appropriate for the patients with calcaneum less than half weight-bearing area.

scholarly journals Reverse sural artery fasciocutaneous flap in soft tissue reconstruction in lower extremity

2020 ◽  
Vol 10 (3) ◽  
pp. 84-87
Author(s):  
Suresh Pandey ◽  
Suraj Bidary
Keyword(s):  
Soft Tissue ◽  
Demographic Data ◽  
Soft Tissue Defect ◽  
Soft Tissue Reconstruction ◽  
Superficial Infection ◽  
Pedicle Flap ◽  
Satisfactory Outcome ◽  
Flap Procedure ◽  
Tissue Reconstruction ◽  
Sural Artery

Background: Soft tissue defect around distal leg, ankle and heel region is a challenging task for an orthopaedic surgeon. Sural artery reverse fasciocutaenous flap has been widely used and is a successful method for soft tissue reconstruction in such situation. This study aimed to find out the result of sural artery distal based pedicle flap in managing soft tissue recon­struction around the ankle and distal leg. Methods: This was a retrospective study of 12 cases of sural artery based fasciocutaenous flap done between January 2015 to December 2019. Medical records were used to find the details of demographic data, operative details and post-operative status of the patients. Patients were contacted for the final follow up at minimum of 6 months after operation for assessment of the outcome. Demographic and clinical data were entered in excel chart and the clinical result was analyzed using SPSS software version 20.0. Results: There were total of 12 patients who underwent sural artery flap procedure. Among them, 10 were male and 2 females with mean age of 39 (range, 25-52) years. Eleven flaps survived with satisfactory functional outcome. One had complete flap necrosis, two had patchy margin necrosis and two had superficial infection which healed well with minor debridement and antibiotics. Conclusions: Sural artery based reverse fasciocutaenous flap is good and technically easier option for an orthopaedic surgeons for the soft tissue reconstruction around ankle, heel and distal leg in traumatic, infective or other etiology with satisfactory outcome in most of the patients.

scholarly journals Soft Tissue Reconstruction around the Ankle with Sural Artery Flap

2018 ◽  
Vol 36 (3) ◽  
pp. 101-106
Author(s):  
Maruf Alam Chowdhury ◽  
Shafquat Hussain Khundkar ◽  
Md Ayub Ali ◽  
Md Obaidul Islam
Keyword(s):  
Soft Tissue ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Good Alternative ◽  
Soft Tissue Reconstruction ◽  
Flap Necrosis ◽  
Short Operative Time ◽  
Sural Flap ◽  
Number Of Patients ◽  
Sural Artery

Reconstruction for injuries around the ankle becomes a challenge due to limitation of available similar or near similar tissue. Tendons, bones and joints are frequently exposed after trauma because of the thinness of the subcutaneous tissue around the ankle. A durable flap with good texture, reliable vascularity, good arc of rotation and minimum donor site morbidity is always desired for coverage of such defect. Traditionally local flaps are used for resurfacing but their use is limited by their size and arc of rotation. This study was done in the dept. of Plastic Surgery, NITOR from Dec, 2012 to Feb, 2016. Total number of patients was 50 and their age varied from 7 years to 55 years. Among the 50 patients, 41 patients recovered uneventfully, 8 patients showed partial flap necrosis and complete flap necrosis in 1 patient. The distally based sural flap is a versatile and reliable flap for coverage of soft tissue defects around the ankle. Most of the cases were single stage procedure except extended reverse sural flap. The dissection is easy with short operative time and minimum morbidity. Thus the superficial sural artery flap can be used as a good alternative to microsurgical reconstruction.J Bangladesh Coll Phys Surg 2018; 36(3): 101-106

scholarly journals Reverse sural flap – A feasible option for oncological defects of the lower extremity, ankle, and foot: Our experience from Northeast India

2019 ◽  
Vol 08 (04) ◽  
pp. 255-257
Author(s):  
Abhijit Talukdar ◽  
Jitin Yadav ◽  
Joydeep Purkayastha ◽  
Niju Pegu ◽  
Pritesh R. Singh ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Northeast India ◽  
Histopathological Diagnosis ◽  
Soft Tissue Defects ◽  
Sural Flap ◽  
Feasible Option ◽  
Sural Artery ◽  
Tissue Defects ◽  
Ankle And Foot

Abstract Background: Soft-tissue management around the lower third of the leg and foot presents a challenge to the surgeon. To achieve local control of tumor, additional surgical margins are required, thus creating large soft-tissue defects. The reverse sural artery flap (RSAF) is a popular option for many of these defects. Materials and Methods: This is a retrospective study of 26 patients who underwent resection of tumor around the lower leg, ankle, and foot, and reconstruction with RSAF was performed at our institute from 2012 to 2018. Results: Among the 26 studied patients, aged between 22 and 71 (mean age: 50.8) years, 5 were female and rest were male. The most common site of involvement by tumor was heel (42.3%), followed by sole (26.9%). The most common histopathological diagnosis was melanoma (61.5%), followed by squamous cell carcinoma (26.9%) and soft-tissue sarcoma (11.5%). Conclusion: The distally based sural flap is a reliable flap for the coverage of soft-tissue defects following oncological defects of the distal lower extremity and foot.

The Distally Based Sural Flap for the Reconstruction of Ankle and Foot Defects in Pediatric Patients

2016 ◽  
Vol 77 (1) ◽  
pp. 97-101 ◽  
Author(s):  
Huaiyuan Zheng ◽  
Juan Liu ◽  
Xinyi Dai ◽  
Arndt F. Schilling
Keyword(s):  
Pediatric Patients ◽  
Sural Flap ◽  
Distally Based ◽  
Distally Based Sural Flap ◽  
Ankle And Foot

scholarly journals Distally based sural flap for ankle and foot coverage in children

2016 ◽  
Vol 102 (1) ◽  
pp. 111-116 ◽  
Author(s):  
A. Grandjean ◽  
C. Romana ◽  
F. Fitoussi
Keyword(s):  
Sural Flap ◽  
Distally Based ◽  
Distally Based Sural Flap ◽  
Ankle And Foot

scholarly journals Reliability of distally based sural flap in elderly patients: comparison between elderly and young patients in a single center

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ping Peng ◽  
Zhonggen Dong ◽  
Jianwei Wei ◽  
Lihong Liu ◽  
Zhaobiao Luo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Elderly Patients ◽  
Young Patients ◽  
The Elderly ◽  
Sural Flap ◽  
Flap Viability ◽  
Group A ◽  
Distally Based ◽  
Group B ◽  
Distally Based Sural Flap

Abstract Background Reconstructions the soft-tissue defects of the distal lower extremities in the elderly patients (≥ 60 years old) are full of challenges because of many comorbidities. The purpose of this study was to report the clinical application of the distally based sural flap in the elderly patients, and to verify the reliability of this flap in the elderly patients. Methods Between March of 2005 and December of 2019, 53 patients aged over 60-year-old and 55 patients aged 18 to 30-year-old who underwent the procedure have been included in this study. The reconstruction outcomes, medical-related complications, flap viability-related complications and potential risk factors are compared between the group A (≥ 60 years old) and group B (ranging from 18 to 30 years old). Results The partial necrosis rate in group A (9.43%) is higher than group B (9.09%), but the difference is not significant (P > 0.05). The constitute ratio of the defects that were successfully covered using the sural flap alone or combining with simple salvage method (i.e., skin grafting) is 96.22% and 98.18% in group A and B, respectively (P > 0.05). The differences of the risk flaps factors that affected the survival of distally based sural flap were not significant between group A and B (P > 0.05). Conclusions The distally based sural flap can be effectively used to repair the soft-tissue defect of the lower extremity in the elderly patients. It is safe and reliable to harvest and transfer the flap in one stage, and the delay surgery is not necessary.

Nanofiber-hydrogel composite–mediated angiogenesis for soft tissue reconstruction

2019 ◽  
Vol 11 (490) ◽  
pp. eaau6210 ◽  
Author(s):  
Xiaowei Li ◽  
Brian Cho ◽  
Russell Martin ◽  
Michelle Seu ◽  
Chi Zhang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Rabbit Model ◽  
Soft Tissue Defect ◽  
Fat Grafting ◽  
Foreign Body Response ◽  
Soft Tissue Reconstruction ◽  
Hydrogel Composite ◽  
Tissue Flaps ◽  
Tissue Restoration

Soft tissue losses from tumor removal, trauma, aging, and congenital malformation affect millions of people each year. Existing options for soft tissue restoration have several drawbacks: Surgical options such as the use of autologous tissue flaps lead to donor site defects, prosthetic implants are prone to foreign body response leading to fibrosis, and fat grafting and dermal fillers are limited to small-volume defects and only provide transient volume restoration. In addition, large-volume fat grafting and other tissue-engineering attempts are hampered by poor vascular ingrowth. Currently, there are no off-the-shelf materials that can fill the volume lost in soft tissue defects while promoting early angiogenesis. Here, we report a nanofiber-hydrogel composite that addresses these issues. By incorporating interfacial bonding between electrospun poly(ε-caprolactone) fibers and a hyaluronic acid hydrogel network, we generated a composite that mimics the microarchitecture and mechanical properties of soft tissue extracellular matrix. Upon subcutaneous injection in a rat model, this composite permitted infiltration of host macrophages and conditioned them into the pro-regenerative phenotype. By secreting pro-angiogenic cytokines and growth factors, these polarized macrophages enabled gradual remodeling and replacement of the composite with vascularized soft tissue. Such host cell infiltration and angiogenesis were also observed in a rabbit model for repairing a soft tissue defect filled with the composite. This injectable nanofiber-hydrogel composite augments native tissue regenerative responses, thus enabling durable soft tissue restoration outcomes.

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