The large feet Defects Reconstruction by Large Sural Grafts Using Propeller-Technique

H.E. Samoilenko

Abstract


The aim of the study was to improve the results of the treatment of defects of distal low extremity using plastic and reconstructive interventions. Materials and methods. Wide soft tissue defects of the distal parts of the lower extremities, particularly the Achilles tendon, ankle, heel, exposing deep anatomical structures are challenges while choosing the methods of plastic closure. The island flap on the artery accompanying the surface sural nerve can be used for closure of the wound defects in this area. We have performed the plastic wound closure with island megaflap (386.7 ± 19.3 сm2 surface), supplied with the sural artery to the distal base, using the Propeller-technique in 4 patients. Results and discussion. All flaps have taken root. In all cases, the sural nerve was the part of the flap. The donor site was closed with the split-skin-graft simultaneously. Conclusions. Plastic operations have been performed in one stage. The sural flap has a wide of rotation arc, and its stability allows use the described technique in closing of large defects on the support surface (heel, foot, etc.).


Keywords


plastic; wounds; perforator artery; sural nerve

References


Masquelet A.C. Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: Anatomic study and clinical experience in the leg / A.C. Masquelet, M.C. Romana, G. Wolf // Plast. Reconstruct. Surg. — 1992. — Vol. 89. — P. 1115-1121.

Ayyappan T. Super sural neurofasciocutaneous flaps in acute traumatic heel reconstructions / T. Ayyappan, A. Chandha // Plast. Reconstr. Surg. — 2002. — Vol. 109. — P. 2307-2313.

Слєсаренко С.В. Використання «сурального» шкірно-фасціального клаптя на дистальній основі для заміщення ранових дефектів нижньої кінцівки / С.В. Слєсаренко, П.О. Бадюл // Хірургія України. — 2008. — № 1(25). — С. 44-50.

Hsieh C.H. Distally based sural island flap for the reconstruction of a large soft tissue defect in an open tibial fracture with occluded anterior and posterior tibial arteries — a case report / C.H. Hsieh, C.C. Liang, N.S. Kueh еt al. // Br. J. Plast. Surg. — 2005. — № 58. — Р. 112-115.

Nakajima H. Accompanying arteries of the lesser saphenous vein and sural nerve: anatomic study and its clinical applications / H. Nakajima, N. Imanishi, S. Fukuzumi еt al. // Plast. Reconstr. Surg. — 1999. — № 103(1). — Р. 104-120.

Фисталь Э.Я. Островковый суральный лоскут в реконструктивной хирургии посттравматических дефектов области голеностопного сустава и стопы / Э.Я. Фисталь, Г.Е. Самойленко, Я.А. Роспопа // Пластична та реконструктивна хірургія. — К., 2010. — № 1. — С. 21-28.

Бадюл П.О. Можливості застосування вакуум-терапії при порушеннях венозного відтоку в острівцевих клаптях / П.О. Бадюл, Г.Є. Самойленко, Н.М. Нор, К.С. Слєсаренко // Клінічна хірургія. — 2015. — № 7. — С. 52-54.

Rezende M.R. Skin coverage of the middle-distal segment of the leg with a pedicled perforator flap / M.R. Rezende, N.T. Rabelo, T.H. Wei еt al. // J. Orthop. Trauma. — 2010. — № 24(4). — Р. 236-243.

Chang S.M. Distally based perforator propeller sural flap for foot and ankle reconstruction: a modified flap dissection technique / S.M. Chang, X. Wang, Y.G. Huang еt al. // Ann. Plast. Surg. — 2014 Mar. — № 72(3). — Р. 340-5.

Shannen A.P. Sural Versus Perforator Flaps for Distal Medial Leg Wounds / A.P. Schannen, L. Truchan, K. Goshima еt al. // Orthopedics. — 2015. — № 38(12). — Р. e1059-e1064.




DOI: https://doi.org/10.22141/1997-2938.1-2.30-31.2016.78094

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