Reconstruction of Soft Tissue Defects of Lower Leg, Ankle and Foot using Sural Flap

Česká verzia

Authors: R. Veselý; V. Procházka ; J. Kočiš; L. Paša
Authors place of work: Klinika traumatologie LF MU v Úrazové nemocnici v Brně, přednosta: prof. MUDr. P. Wendsche, CSc. ; Úrazová nemocnice Brno - Traumacentrum, ředitel: prof. MUDr. M. Janeček, CSc.
Published in the journal: Rozhl. Chir., 2007, roč. 86, č. 3, s. 134-138.
Category: Monothematic special - Original

Summary

Covering soft-tissue injuries on the lower third of the leg, ankle joint and on the calcaneal part of the foot has so far been the domain for free flap use. The distally based superficial sural artery flap with vascular axis of the sural nerve was first described by Masquelet.

We treated 31 patients after injuries with this method. No flap failed. Necrosis of the edges affected three flaps. Most fiaps showed slight venous congestion.

The authors present their clinical experience using this technique. The advantages are the following:
the blood supply is reliable, elevation is easy and quick and major arteries are not sacrified.

Key words:
sural flap – neurofasciocutaneous flap – distal leg and foot reconstruction

Zdroje

1. Di Benedetto, G., Bertani, A., Pallua, N. The free latissimus dorsi flap revisited: a primary option for coverage of wide recurrent lumbosacral defects. Plast. Reconstr. Surg., 2003, roč. 111, č. 4, s. 1576–1578.

2. Fischer, T., Kammer, E., Noever, G. Distal pedicled sural island flap-plasty for defect coverage of the distal lower extremity. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 2001, roč. 33, č. 3, s. 108–112.

3. Hasegawa, M., Torii, S., Katoh, H. The distally based superficial sural artery flap. Plast. Reconstr. Surg., 1993, roč. 91, č. 6, s. 1012–1020.

4. Hyakusoku, H., Tonegawa, H., Fumiiri, M. Coverage with a T-shaped distally based sural island fasciocutaneous flap. Plast. Reconstr. Surg., 1994, roč. 94, č. 4, s. 872.

5. Jeng, S. F., Wic, F. C. Distally based sural island flap for foot and ankle reconstruction. Plast. Reconstr. Surg., 1997, roč. 99, č. 3, s. 744–750.

6. Koski, E. A.,Koukkanen, H. O., Koskinen, S. K. Reconstruction of soft tissue after complicated calcaneal fractures. Scand. J. Plast. Reconstr. Surg., 2004, roč. 38, č. 2, s. 284.

7. Masquelet, A. C., Romana, M. C. Skin island flaps supplied by the vascular axis sensitive superficial nerves: anatomie study and clinical experience in the leg. Plast. Reconstr. Surg., 1992, roč. 90, č. 7,s. 1115–1121.

8. Rajacic, N., Darweesh, M., Gang, R. K. The distally based superficial flap for reconstruction of the lower leg and foot. Br. J. Plast. Surg., 1996, roč. 49, č. 4, s. 383.

9. Breidenbach, W., Terzis, J. K. The anatomy of free vascularized nerve grafts. Clin. Plast. Surg., 1984, roč. 45, č. 11, s. 65–71.

10. Taylor, G., Ham, F. J. The free vascularized nerve grafts. Plast. Reconstr. Surg., 1976, roč. 57, č. 4, s. 413.