RSS-Feed abonnieren
DOI: 10.1055/s-0032-1333321
Using the Pedicle Flap for Taking Pressure off the Pedicle in Distally Based Skin Flaps
Publikationsverlauf
31. August 2012
06. November 2012
Publikationsdatum:
09. Januar 2013 (online)
Abstract
This report describes our experience using the pedicle flap for taking pressure off the pedicle in distally based skin flaps. Between July 2007 and March 2010, distally based skin flaps were used to treat 34 patients with soft tissue defects in the lower leg, ankle, and foot. A pedicle flap was used to take pressure off the pedicle in all of these flaps. There were 21 men and 13 women with a mean age at surgery of 47 years (range, 21 to 67 years). The sizes of the soft tissue defects varied from 5.0 cm × 2.0 cm to 17.0 cm × 10.0 cm. The pedicle flap sizes varied from 1.0 cm × 1.0 cm to 5.0 cm × 3.5 cm. All flaps survived completely except three, which suffered a marginal partial flap necrosis due to venous congestion. These flaps healed by secondary intention after changing the dressing. Using the pedicle flap takes pressure off the pedicle and facilitates primary closure after transposition of the distally based skin flaps, which is a simple and effective method to prevent complications of these flaps.
-
References
- 1 Benito-Ruiz J, Yoon T, Guisantes-Pintos E, Monner J, Serra-Renom JM. Reconstruction of soft-tissue defects of the heel with local fasciocutaneous flaps. Ann Plast Surg 2004; 52: 380-384
- 2 de Almeida OM, Monteiro Jr AA, Neves RI , et al. Distally based fasciocutaneous flap of the calf for cutaneous coverage of the lower leg and dorsum of the foot. Ann Plast Surg 2000; 44: 367-373 , discussion 373–374
- 3 Ng YH, Chong KW, Tan GM, Rao M. Distally pedicled peroneus brevis muscle flap: a versatile lower leg and foot flap. Singapore Med J 2010; 51: 339-342
- 4 Perrot P, Bouffaut AL, Perret C, Connault J, Duteille F. Risk factors and therapeutic strategy after failure of free flap coverage for lower-limb defects. J Reconstr Microsurg 2011; 27: 157-162
- 5 Jeng SF, Wei FC. Distally based sural island flap for foot and ankle reconstruction. Plast Reconstr Surg 1997; 99: 744-750
- 6 Chen SL, Chen TM, Chou TD, Chang SC, Wang HJ. Distally based sural fasciomusculocutaneous flap for chronic calcaneal osteomyelitis in diabetic patients. Ann Plast Surg 2005; 54: 44-48
- 7 Shao X, Yu Y, Zhang X , et al. Repair of soft-tissue defect close to the distal perforating artery using the modified distally based medial fasciocutaneous flap in the distal lower leg. J Reconstr Microsurg 2011; 27: 145-150
- 8 Chang SM, Zhang F, Yu GR, Hou CL, Gu YD. Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle. Microsurgery 2004; 24: 430-436
- 9 Voche P, Merle M, Stussi JD. The lateral supramalleolar flap: experience with 41 flaps. Ann Plast Surg 2005; 54: 49-54
- 10 Costa-Ferreira A, Reis J, Pinho C, Martins A, Amarante J. The distally based island superficial sural artery flap: clinical experience with 36 flaps. Ann Plast Surg 2001; 46: 308-313
- 11 Jeng SF, Hsieh CH, Kuo YR, Lin TS, Wei FC. Distally based sural island flap. Plast Reconstr Surg 2003; 111: 840-841
- 12 Baumeister SP, Spierer R, Erdmann D, Sweis R, Levin LS, Germann GK. A realistic complication analysis of 70 sural artery flaps in a multimorbid patient group. Plast Reconstr Surg 2003; 112: 129-140 , discussion 141–142
- 13 Noack N, Hartmann B, Küntscher MV. Measures to prevent complications of distally based neurovascular sural flaps. Ann Plast Surg 2006; 57: 37-40
- 14 Levante S, Mebtouche N, Molina V, Cottin P, Bégué T. [The distally based sural flap at the ankle and foot: complications analysis in a 27 cases study]. Ann Chir Plast Esthet 2011; 56: 194-199
- 15 Lei L, He R, Shen M, Cheng P, Li G, Yan W. [Application of pedicle reducing tension flap in the distally-based pedicle flap operation]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2012; 26: 58-60
- 16 Yoshimura M, Imura S, Shimamura K, Yamauchi S, Nomura S. Peroneal flap for reconstruction in the extremity: preliminary report. Plast Reconstr Surg 1984; 74: 402-409
- 17 Chuenkongkaew T, Chayakula N, Srirojanakul S. Reverse-flow posterior tibial island flap: preliminary report of a new fasciocutaneous flap. Ann Plast Surg 1990; 25: 306-311
- 18 Wee JT. Reconstruction of the lower leg and foot with the reverse-pedicled anterior tibial flap: preliminary report of a new fasciocutaneous flap. Br J Plast Surg 1986; 39: 327-337
- 19 Mateev MA, Kuokkanen HO. Reconstruction of soft tissue defects in the extremities with a pedicled perforator flap: series of 25 patients. J Plast Surg Hand Surg 2012; 46: 32-36
- 20 Sonmez E, Safak T. Reconstruction of the soft tissue defects of foot and ankle with neural-island flaps: mono-institutional case series. J Reconstr Microsurg 2011; 27: 403-408
- 21 Li F, Zeng B, Fan C, Chai Y, Ruan H, Cai P. Distally based extended peroneal artery septocutaneous perforator cross-bridge flap without microvascular anastomoses for reconstruction of contralateral leg and foot soft tissue defects. J Reconstr Microsurg 2010; 26: 243-249
- 22 Kang HG, Kim JH, Cho HS, Han I, Oh JH, Kim HS. Soft tissue reconstruction of the foot using the distally based island pedicle flap after resection of malignant melanoma. Clin Orthop Surg 2010; 2: 244-249
- 23 Almeida MF, da Costa PR, Okawa RY. Reverse-flow island sural flap. Plast Reconstr Surg 2002; 109: 583-591
- 24 Sonmez E, Safak T. Reconstruction of the soft tissue defects of foot and ankle with neural-island flaps: mono-institutional case series. J Reconstr Microsurg 2011; 27: 403-408
- 25 Dragu A, Bach AD, Kneser U, Horch RE. Two easy and simple modifications when using a distally based sural flap to reduce the risk of venous congestion. Plast Reconstr Surg 2008; 122: 683-684 , author reply 684
- 26 Tan O, Atik B, Bekerecioglu M. Supercharged reverse-flow sural flap: a new modification increasing the reliability of the flap. Microsurgery 2005; 25: 36-43
- 27 Loonen MP, Kon M, Schuurman AH, Bleys RL. Venous bypass drainage of the small saphenous vein in the neurovascular pedicle of the sural flap: anatomical study and clinical implications. Plast Reconstr Surg 2007; 120: 1898-1905
- 28 Buluç L, Tosun B, Sen C, Sarlak AY. A modified technique for transposition of the reverse sural artery flap. Plast Reconstr Surg 2006; 117: 2488-2492