Surgical review: the versatile reverse Xow sural artery Xap for lower 1/3 leg and foot defects: clinical series
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Sandeep Kansal · Pradeep Goil · Jagdeep Singh
- چاپ و سال / کشور: 2011
Description
Background The soft tissue defects of lower third leg, ankle, and foot present a challenging problem because of the paucity of local tissue and poor circulation of skin in that region. Various forms of coverage including muscle Xaps, fascial Xaps, and free Xaps are used for reconstruction. Each have their speciWc indications and inherent disadvantages. Distally based fasciocutaneous Xap supplied by vascular axis around sural nerve is intensively researched and constitutes another important alternative to lower third and foot reconstruction. Patients and method In our department, we have treated 166 patients from January 2004 to December 2008 with reverse sural Xap. Majority of patients were due to road traYc accident (RTA). Distal pivot point was kept approximately 5 cm from lateral malleolus, thus preserving the distal most perforator, and the Xap was turned and insetted into the defect. Donor site was covered with a split thickness graft. Postoperative follow-up period was 15 days to 1 year at regular intervals. Results The procedure was uneventful in 142 cases. Infection/discharge occurred in 12 cases. Partial Xap necrosis occurred in 10 cases, with resulting need for minor surgery (debridement and split thickness graft). Total Xap necrosis occurred in 2 cases. Conclusion Distally based sural Xap oVers reconstruction of foot, ankle, and lower third leg with a reliable blood supply, easy elevation, and long vascular pedicle with large arc of rotation. Also, there is no sacriWce of major arteries. However, main disadvantages are sacriWce of sural nerve and unsightly scarring of upper calf.
Eur J Orthop Surg Traumatol DOI 10.1007/s00590-011-0768-z Received: 7 August 2010 / Accepted: 26 January 2011
