Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study

Palukuri Lakshmi, Shreedharala Srinivas, D. Madhulika, Sanujit Pawde, Ajo Sebastian, Swati Sankar, Sandeep Reddy Chintha
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Abstract

Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm 2 , and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm 2 , and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for re-constructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications
印度近端腓肠肌皮瓣用于膝关节周围和腿部近三分之一处软组织缺损的重建:一项临床研究
目的:重建膝关节周围和腿部近端三分之一处的缺损需要薄而柔韧的皮肤以及稳定而有感觉的软组织覆盖。本研究分析了使用近端腓肠肌皮瓣覆盖此类缺损的方法。方法:这项前瞻性临床干预研究涉及 10 名膝关节和腿部近端三分之一处有软组织缺损的患者。这些患者接受了基于近端腓肠肌皮瓣的重建手术。研究分析了各种因素,包括年龄、性别、病因、缺损位置和表现、缺损尺寸、皮瓣细节、术后并发症和随访。研究结果共有 10 个病例,均为 20 至 65 岁的男性。最常见的受伤原因是道路交通事故造成的外伤。大部分缺损位于腿的近三分之一处,尤其是前外侧。缺损大小从6×3到15×13厘米2不等,使用这种皮瓣可以覆盖16厘米×14厘米的大面积缺损。皮瓣的大小从7×4到16×14平方厘米不等,蒂长为10到15厘米。在所有病例中,供体部位都是通过分割植皮来实现闭合的。这种皮瓣始终能在缺损处提供薄、柔韧、稳定和持久的软组织覆盖,且无功能障碍,供体部位发病率极低。有两个病例出现了并发症,包括远端皮瓣坏死和供体部位移植物脱落。结论:以近端为基础的腓肠肌筋膜皮瓣是重建膝关节周围和腿部近三分之一处中大型软组织缺损的主要方法。这种技术能提供纤薄、可靠、敏感和稳定的软组织覆盖,并能覆盖较大的缺损,并发症极少。
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