scholarly journals EVALUATION OF THE REVERSE SURALARTERY FLAP IN THE PAEDIATRIC AGE GROUP

2020 ◽  
pp. 1-3
Author(s):  
Macnol Afonso
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Group Method ◽  
Age Group ◽  
Soft Tissue Defects ◽  
Loss Of Function ◽  
No Donor ◽  
Paediatric Age ◽  
Sural Artery ◽  
Tissue Defects

Introduction: The Reverse sural artery flap can be used to cover soft tissue defects of the distal leg, ankle and proximal foot. The flap has rarely been evaluated in the paediatric age group. Method: A Retrospective study was undertaken including four children, with soft tissue defects of the distal leg and foot covered using a distally based Reverse sural artery flap. Results: All flaps survived (100%). Venous congestion did not occur in any patient. Marginal flap necrosis occurred in one patient (25%). Reinsetting of the flap was done in one patient (25%). There was no donor site morbidity. Conclusions: The reverse sural artery flap can be easily raised, while sparing the major blood vessels and without any major loss of function. As such it can be reliably used to cover defects of the distal leg and foot in the paediatric age group

scholarly journals Reverse sural artery fasciocutaneous flap cover for soft tissue defects in distal one third of leg, ankle and foot in a tertiary care center

2019 ◽  
Vol 6 (7) ◽  
pp. 2433
Author(s):  
Prakashkumar M. N. ◽  
Pramod T.
Keyword(s):  
Soft Tissue ◽  
Care Center ◽  
Donor Site ◽  
Tertiary Care ◽  
Soft Tissue Defect ◽  
Safe Procedure ◽  
Soft Tissue Defects ◽  
Sural Artery ◽  
Flap Cover ◽  
Tissue Defects

Background: Soft tissue defect management around the lower-third of the leg, ankle and dorsal feet with exposed tendons, bones and orthopaedic implants is a challenge faced by a majority of surgeons. A locally available, versatile, durable flap is the preferred option for coverage of such defects, in the absence of micro vascular surgery facility.Methods: This prospective study was conducted at Department of General Surgery, Kodagu Institute of medical sciences from March 2018 to May 2019, on 10 consecutive patients with soft tissue defects and exposed bones, tendons and joints of distal-third of leg and foot. We harvested moderate sized reverse sural artery flaps, to cover the defects. After perforator marking with Doppler, flap was planned in reverse, and procedure was performed. Factors like size of defect, flap size, width of pedicle, comorbid factors and complications following surgery were taken into account for the study.Results: A majority of flaps provided a good coverage for defects and graft was well taken in donor site in all cases. One patient had marginal flap necrosis who was elderly and diabetic, he was managed conservatively, another patient had distal flap venous congestion which settled by itself with conservative management.Conclusions: Reverse sural artery flap (RSAF) cover is versatile, reliable and safe procedure, which was efficiently used to treat patients with wounds of distal leg, and foot.

scholarly journals Extended reverse sural artery pedicle flap: a versatile and reproducible option for coverage of ankle and foot defects

2019 ◽  
Vol 7 (3) ◽  
pp. 866
Author(s):  
Bhushan R. Patil ◽  
Chandrashekhar Wahegaonkar ◽  
Nikhil Agarkhedkar ◽  
Bharat Bhushan Dogra
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Free Tissue Transfer ◽  
Soft Tissue Defects ◽  
Pedicle Flap ◽  
Tissue Transfer ◽  
Major Vessel ◽  
Sural Artery ◽  
Tissue Defects ◽  
Ankle And Foot

Background: Coverage of soft tissue defects around distal third of the leg, particularly ankle and foot is a common situation faced by a plastic and reconstructive surgeon. Options available for such defects are limited due to scarcity of additional soft tissue that can be used without exposing tendons or bone. Associated conditions such as major vascular compromise, comorbidities and lack of facilities or expertise make free tissue transfer less preferred. Distally based sural artery flap has been a frequently used flap in such conditions, easy to perform and has reproducible results. We extended the reach of the flap and reproduced the results.Methods: We performed extended reverse sural artery pedicled flaps in 19 patients who presented to us between 2015 to 2017 with soft tissue defects around ankle and foot. Patients included 15 post RTA, 2 diabetic foot, 1 post resection defect and 1 post burn contracture release defect. Size of the defect ranged between 8x6cm to 14x10cm. Average follow up period was ranging from 8 months to 2.5 years.Results: All the flaps healed well without any obvious complications except one patient in whom marginal necrosis (2 cm margin of distal most flap) was observed and was secondarily treated with skin grafting.Conclusions: We observed that extended reverse sural pedicle flap is a rapid, reliable option for coverage of soft tissue defects around ankle and heel, sparing major vessel compromise and lengthy surgical procedure during free tissue transfer. This flap should be the first option for the patients with trauma and defects over weight bearing foot in whom peroneal axis vessels are preserved.

A Comparative Study of the Reverse Sural Fascio-Cutaneous Flap Outcomes in the Management of Foot and Ankle Soft Tissue Defects in Diabetic and Trauma Patients

2018 ◽  
Vol 12 (5) ◽  
pp. 432-438 ◽  
Author(s):  
Chahine Assi ◽  
Camille Samaha ◽  
Moussa Chamoun Moussa ◽  
Tony Hayek ◽  
Kaissar Yammine
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Low Frequency ◽  
Group Versus ◽  
Healing Time ◽  
Diabetic Patients ◽  
Trauma Patients ◽  
Soft Tissue Defects ◽  
Cutaneous Flap ◽  
Tissue Defects

Introduction. Soft tissue defects in the distal leg and foot are challenging conditions for reconstruction. The widely used reverse sural fascio-cutaneous flap (RSFCF) has been reported with large variation in complication frequency. Some authors reported higher complications in the diabetic population when compared with trauma patients. We compared the reliability of the RSFCF in treating such defects among both populations. Methods. This is a retrospective series with a prospective data collection of 24 patients (11 with type 2 diabetes and 13 in trauma settings) treated with an ipsilateral RSFCF for soft tissue defects of the distal leg and the rear foot. Healing events and complications were recorded and compared for both groups. The mean follow-up was 32 months. Results. Diabetic group versus trauma group showed the following results; mean flap healing time of 24 versus 22 days, donor site healing time of 14 versus 16 days, 1 total flap necrosis in both groups, 3 versus 2 cases of skin edge necrosis, 2 cases of temporary venous congestion in both groups, and 8 versus 10 cases of transient hypoesthesia of the lateral border of the foot. No infection was encountered in both groups and no recurrence of infection in the primary infected diabetic patients. Conclusions. We found the RSFCF to be useful, reproducible, and reliable in treating soft tissue defects with a very low frequency of serious complications. Diabetic patients were found to have similar outcomes when compared with trauma patients. Therefore, diabetes might not be a major factor of flap failure. Levels of Evidence: Level III: Therapeutic

scholarly journals Peroneal perforator pedicle propeller flap for lower leg soft tissue defect reconstruction: Clinical applications and treatment of venous congestion

2017 ◽  
Vol 45 (3) ◽  
pp. 1074-1089 ◽  
Author(s):  
Lifeng Shen ◽  
Yiyang Liu ◽  
Chun Zhang ◽  
Qiaofeng Guo ◽  
Wenhua Huang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Lower Leg ◽  
Soft Tissue Defect ◽  
Venous Congestion ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Propeller Flap ◽  
Perforator Vessel ◽  
Tissue Defects

Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound. The flap was designed based on the preoperatively-identified perforator location, with the posterior border of the fibula employed as an axis, and the perforator vessel as the pivot point of rotation. Patients were followed-up to determine the outcomes. Results The study analysed 36 patients (mean age, 39.7 years). The majority of the soft tissue defects were on the heel (20; 55.6%). The donor-site of the flap was closed in 11 patients by direct suturing and skin grafting was undertaken in 25 patients. Postoperative complications included venous congestion (nine patients), which was managed with delayed wound coverage and bleeding therapy. All wounds were eventually cured and the flaps were cosmetically acceptable. Conclusions The peroneal perforator pedicle propeller flap is an appropriate choice to repair soft tissue defects of the distal limbs.

Preliminary Experience with Perforator Flaps in Reconstruction of Soft-Tissue Defects of the Foot and Ankle

2005 ◽  
Vol 26 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Frederick J. Duffy ◽  
James W. Brodsky ◽  
Christian T. Royer
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Tissue Loss ◽  
Soft Tissue Reconstruction ◽  
Foot And Ankle ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Microsurgical Reconstruction ◽  
Tissue Defects

Background: Microsurgical reconstruction has improved limb salvage in patients who because of many etiologies have soft-tissue loss from the lower extremities. Free-tissue transfer to the foot and ankle often interferes with postoperative function and footwear because of the bulk of a muscle flap. The foot and ankle often are best treated using thin flaps that will not contract and fibrose, particularly if secondary procedures are required. We hypothesized that perforator flaps, which are thin free-tissue transfers consisting of skin and subcutaneous tissue, both diminish donor site morbidity and are ideally suited for soft-tissue reconstruction of the foot and ankle. Methods: Ten patients had free- tissue transfers to the foot and ankle using perforator flaps during a 2-year period. Four had acute posttraumatic wounds, three had soft tissue defects with exposed hardware or bone graft after reconstructive surgery, and three had large soft-tissue defects after foot infection secondary to diabetes. Nine had reconstruction with anterolateral thigh perforator flaps and one had reconstruction with a deep inferior epigastric artery (DIEP) perforator flap. Results: All flaps survived. There were no deep infections. Three flaps had minor tissue loss requiring subsequent small skin grafts, all of which healed. There were no donor site complications and no interference of muscle function at the donor sites. Custom shoewear was not required to accommodate the flaps. Conclusion: This series highlights the success and utility of perforator flaps in microsurgical reconstruction of the foot and ankle. The greatest advantage of perforator flaps is the diminished donor site morbidity, which was achieved while maintaining high microsurgical success rates. These skin and fat flaps remained pliable and contracted less than muscle flaps, allowing for smooth tendon gliding and easy flap elevation for secondary orthopaedic procedures.

scholarly journals Adipofascial perforator flaps: Its role in reconstruction of soft-tissue defects of lower leg and ankle

2018 ◽  
Vol 51 (02) ◽  
pp. 216-221 ◽  
Author(s):  
Deepak Nanda ◽  
Shamendra Anand Sahu ◽  
Durga Karki ◽  
Sanjay Kumar ◽  
Amrita Mandal
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Soft Tissue Defect ◽  
Soft Tissue Defects ◽  
Adipofascial Flap ◽  
Tibial Artery ◽  
Split Skin ◽  
Tissue Defects

ABSTRACT Background: Despite advances in surgical skills, adipofascial flaps are still less preferred option for coverage of leg defect. We evaluate the use of perforator-based adipofascial flap in small-to-medium-sized soft-tissue defects in the lower limb. Patients and Methods: After localisation of perforators along the major axial vessels in the lower limb using handheld Doppler, adipofascial flap based on the nearest best perforator of anterior tibial artery, posterior tibial artery and peroneal artery was raised to cover soft-tissue defect in 21 patients. The flap was transposed over the defect and covered by split-skin graft. Donor site was primarily closed. Flap complications, functional and aesthetic outcomes are noted in follow-up. Results: There was partial loss of flap in five patients. After debridement and dressings, split-skin grafting was done for four patients and one patient was managed with local flap. Scar over the flap was stable with no reports of recurrent ulceration or breakdown of wound in 6-month follow-up. Four of five patients reported adequate healing of the fractured bone. Average visual analogue score was 8.24/10 for appearance of donor site as evaluated by the patient. Conclusions: Perforator-based adipofascial flap is a good alternative for coverage of small-to-medium-sized soft-tissue defect of the leg, particularly over the malleolus and lower part of the leg. Use of adipofascial tissue and primary closure of the donor site causes minimal donor-site morbidity. Adipofascial perforator flap provides aesthetically superior recipient-site scar with satisfactory functional outcome.

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 Free Thoracodorsal Artery Polyfoliate Perforator Flaps for Repairing Multiple Soft Tissue Defects in the Hand

2021 ◽  
Author(s):  
Wenquan Ding ◽  
Jianbo Xue ◽  
Yingling Zhou ◽  
Lingfeng He ◽  
Xiaofeng Wang
Keyword(s):  
Soft Tissue ◽  
Evaluation System ◽  
Operative Time ◽  
Donor Site ◽  
Active Movement ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Short Operative Time ◽  
Thoracodorsal Artery ◽  
Tissue Defects

Abstract Background: Hand injury is commonly associated with multiple soft tissue defects. Polyfoliate flaps grafting is the optimal approach for multiple wounds.To confirm the feasibility of clinical using of free thoracodorsal artery polyfoliate perforator flaps for repairing multiple soft tissue defects in the hand. Methods: Fifteen patients with hand soft tissue defects that were repaired using free thoracodorsal artery polyfoliate perforator flaps from January 2015 to February 2018 was retrospectively analysed. The survival rate, the operative time, the appearance and sensory recovery of the flaps, and hand function were evaluated. Results: The flaps of all 15 patients survived. Vascular crisis occurred in one patient, and the flap was saved after exploratory operation. The 15 patients were followed up for 12-26 months. Sensation in the flaps was partially recovered in all 15 patients. The wound in the donor area was closed directly with sutures. Obvious scar hyperplasia was noted in three patients. A puffed appearance in the recipient area was noted in four patients.To obtain a more satisfactory appearance, revision of the flap was performed once in these four patients. The Total Active Movement (TAM) evaluation system was used to assess the results, which were considered excellent in seven patients, good in six patients, fair in two patients, and poor in none of the patients. Ten of the 15 patients returned to their primary jobs. Conclusion: Free thoracodorsal artery polyfoliate perforator flaps are appropriate for repairing multiple soft tissue defects in the hand, offer a satisfactory appearance, require a short operative time, and have little impact on the function and aesthetics of the donor site.

scholarly journals Functional and aesthetic outcomes of first dorsal metacarpal artery flap for thumb reconstruction: a prospective study

2020 ◽  
Vol 7 (7) ◽  
pp. 2268
Author(s):  
Sujana Ravada ◽  
Surya Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Sensory Function ◽  
Soft Tissue Defects ◽  
Aesthetic Outcome ◽  
Dorsal Metacarpal Artery ◽  
The Mean ◽  
The Aesthetic ◽  
Tissue Defects ◽  
First Dorsal Metacarpal Artery

Background: Reconstruction of soft tissue defects of the thumb, with exposure of tendon, joint or bone, has been a challenging problem. Surgical options include local, regional or free flaps. Here, we have evaluated the functional and aesthetic outcomes of first dorsal metacarpal artery (FDMA) island flap in reconstruction of various soft tissue defects of the thumb.Methods: Between January 2018 and January 2019, twenty patients with post-traumatic and post-infective thumb defects underwent FDMA flaps. Sensory function was evaluated with static 2 point discrimination and mobility of the thumb was tested by the Kapandji score. The aesthetic outcome was also assessed.Results: The mean defect size was 39.9×19.95 mm. Eighteen flaps survived completely and one had distal flap necrosis and one had superficial epidermal peeling which was treated conservatively. The mean static two-point discrimination was 9.3 mm. Cortical reorientation was complete in 45%. The average Kapandji score was 7.9. The aesthetic outcome was excellent in ten, good in eight and poor in two subjects. After a mean follow up period of 11.85 months, most patients regained all functions of the thumb and index finger and were pleased with the cosmetic appearance of the flap and donor site.Conclusions: FDMA flap offers a good quality skin cover for small to moderate sized thumb defects. It is a reliable and versatile flap which is sensate and pliable. It gives excellent functional and aesthetic outcomes with minimal or no donor site morbidity.

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