Distally Based Perforator Propeller Sural Flap for Foot and Ankle Reconstruction

• DOI: 10.1097/sap.0b013e31826108f1
• Publication Date: 2012-12-31T12:27:42Z
• Authors: Shi-Min Chang; Xin Wang; Yi-Gang Huang; Xiao-Zhong Zhu; You-Lun Tao; Ying-Qi Zhang
• Keywords: Peroneal Artery; Perforator flaps; Posterior tibial artery

Distally based perforator propeller sural flaps that pedicled on an isolated from the peroneal artery or posterior tibial are a versatile local reconstructive option for defects of foot and ankle region. However, flap venous congestion is yet difficult problem after operation. We hypothesize containing some adipofascial tissues around axial can preserve tiny return routes, improve drainage, ultimately enhance safety in distally flaps.A prospective case series 12 patients undergoing coverage were included this study January 2008 to December 2010. There 7 posteromedial region 5 posterolateral After identifying proper viable during operation as pivot point, whole was designed eccentric shape. The proximal larger blade fasciocutaneous flap, whereas distal smaller subdermal vascular plexus preserving at least quarter area tissue intact perforator. Postoperatively, swelling classified into 5-grade assessment scale. Flap survival, complications, patient functional recovery evaluated.The measured 4 × 8 6 18 cm (mean, 57.8 cm), cutaneous 2 9.2 cm). rotated 160 180 degrees. noted under grade 9 cases, 3 2, 1 with superficial skin necrosis, which occurred largest our series. All survived uneventfully. mean 13 months follow-up, wounds cured successfully. recovered walking shoe wearing function.Keeping quadrant form perforator-adipofascial-pedicle more routes relieve swelling. This technique should be recommended perforator-pedicled because it enhances does not increase difficulty 180-degree rotation.