Rotational flap versus long plantar flap for transmetatarsal amputation closure following revascularization

IF 0.7 Q4 SURGERY

Journal of Vascular Surgery Cases Innovations and Techniques Pub Date : 2024-11-27 DOI:10.1016/j.jvscit.2024.101696

Vanessa Prado dos Santos MD, PhD , Lucas de Mello Ferreira MD , André Brito Queiroz MD, PhD , Carlos Alberto Silveira Alves MD

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引用次数: 0

Abstract

Objective

The integrity of the plantar flap is important for transmetatarsal amputation (TMA) classic closure. However, in ischemic wounds, the plantar flap can be compromised, making the TMA coverage difficult. The aim of this study was to compare the outcomes of rotational vs long plantar flaps for transmetatarsal amputation closure in patients with dysvascular partial foot amputations.

Methods

We conducted an observational study including revascularized patients with established forefoot gangrene who required TMA. The coverage was performed by classical long plantar flap or rotational flap due to the lack of adequate plantar skin. Seventeen patients were included in the study. TMA was performed after lower limb revascularization in all cases. We compared the wound healing and functional outcomes of the two groups (rotational vs long plantar flap).

Results

The mean age of the sample was 66.5 years (±8.3 years). Eight cases (47%) had open surgical bypass, and nine (53%) had endovascular procedures. Eight cases of rotational flaps (7 medial plantar rotational flaps) and nine classical long plantar flaps were analyzed. Our results demonstrated an overall healing rate of 77% in the sample. There was no significant difference between the surgical techniques evaluated. The healing percentage for the rotational flap group was 75% (6 cases) and 78% (7 cases) for the classical long plantar flap closure (P = .6).

Conclusions

Rotational flap provides a feasible alternative to classical long plantar flap for TMA coverage, showing a satisfactory healing rate for dysvascular foot following revascularization.

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旋转皮瓣与长足底皮瓣在经跖骨截肢血管重建术后闭合中的比较。

目的：足底皮瓣的完整性对经跖骨截肢（TMA）的经典闭合具有重要意义。然而，在缺血性伤口中，足底皮瓣可能受损，使TMA覆盖困难。本研究的目的是比较旋转足底皮瓣和长足底皮瓣在血管异常的部分足截肢患者经跖骨截肢闭合中的效果。方法：我们进行了一项观察性研究，包括需要TMA的前足坏疽血运重建患者。由于缺乏足够的足底皮肤，采用经典的长足底皮瓣或旋转皮瓣进行覆盖。17名患者参与了这项研究。所有病例均在下肢血运重建术后行TMA。我们比较了两组（旋转和长足底皮瓣）的伤口愈合和功能结果。结果：患者平均年龄66.5岁（±8.3岁）。8例（47%）行开腹搭桥手术，9例（53%）行血管内手术。本文对8例足底旋转皮瓣（7例内侧足底旋转皮瓣）和9例经典长足底旋转皮瓣进行了分析。我们的结果显示，样本的整体愈合率为77%。评估的手术技术之间没有显著差异。旋转皮瓣组愈合率为75%（6例），经典足底长瓣闭合组愈合率为78%（7例）（P = .6）。结论：旋转皮瓣为TMA覆盖提供了一种可行的替代方法，对血管重建后血管障碍足具有满意的治愈效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular Surgery Cases Innovations and Techniques SURGERY-

CiteScore

1.00

自引率

14.30%

发文量

219

审稿时长

29 weeks

期刊介绍： Journal of Vascular Surgery Cases and Innovative Techniques is a surgical journal dedicated to publishing peer review high quality case reports, vascular images and innovative techniques related to all aspects of arterial, venous, and lymphatic diseases and disorders, including vascular trauma, malformations, wound care and the placement and maintenance of arterio-venous dialysis accesses with an emphasis on the practicing clinician. The Journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals involved with the management of patients with the entire spectrum of vascular disorders.