Repairing soft tissue defect in forefoot by a retrograded lateral tarsal artery perforator flap pedicled with anterior branch

中华显微外科杂志 Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.1001-2036.2020.01.005

Tao Yang, Guangchao Zhang, Ming-wu Zhou, Zhiyu Hu, Shi-min Li

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引用次数: 0

Abstract

Objective To investigate the surgical method and clinical effect of repairing the forefoot soft tissue defect by the retrograded lateral tarsal artery perforator flap pedicled with the anterior branch. Methods From March, 2015 to October, 2018, 9 patients with soft tissue defects in forefoot were repaired by the retrograded lateral tarsal artery perforator flap pedicled with anterior branch. One patient received an emergency repair and 8 received secondary repair. The wounds were all located in the forefoot. Area of defects were 3.0 cm×2.0 cm-5.0 cm×4.0 cm; flap areas were 3.5 cm×3.0 cm-6.0 cm×4.5 cm. The donor sites of flap were repaired with full thickness skin graft. All patients received postoperative followed-up through the visits of outpatient clinics, WeChat or telephone reviews. Results Eight flaps survived successfully and the wounds healed by first intention; One flap had venous crisis 2 days after surgery and after having removed stitches of the pedicle of flap, only distal skin necrosis occurred. And healed after changing treatment. All the skin graft in donor sites of flaps survived well. All patients were entered 3 to 18 months postoperative follow-up. The shape of flaps had good textures and were not bloated. The sensation of flaps partially recovered. In the last followed-up, 8 flaps were assessed by the American Orthopaedic Foot and Ankle Society (AOFAS) middle foot scoring standard. The results were excellent in 5 cases, good in 2 cases and poor in 1 case, with the good and excellent rate of 87.5%. Conclusion The retrograde lateral tarsal artery perforator flap pedicled with the anterior branch is one of the effective methods to repair the soft tissue defect in forefoot without damaging the main trunk of dorsal pedal artery. It features a reliable blood supply to the flap and a relatively simple surgical procedure. Key words: Lateral tarsal artery perforator flap; Anterior branch; Forefoot; Repair

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以前支为蒂的跗外侧动脉逆行穿支皮瓣修复前掌软组织缺损

目的探讨以前支为蒂的跗外侧动脉逆行穿支皮瓣修复前掌软组织缺损的手术方法及临床效果。方法自2015年3月至2018年10月，采用以前支为蒂的跗外侧动脉逆行穿支皮瓣修复9例足前部软组织缺损。1名患者接受了紧急修复，8名患者接受二次修复。伤口都在前掌。缺陷面积为3.0cm×2.0cm～5.0cm×4.0cm；皮瓣面积为3.5cm×3.0cm～6.0cm×4.5cm。所有患者均通过门诊、微信或电话随访进行术后随访。结果8例皮瓣均成功成活，创面均达到预期愈合；其中一个皮瓣在术后2天出现静脉危象，在切除皮瓣蒂缝线后，仅发生远端皮肤坏死。并在改变治疗后痊愈。皮瓣供皮部位的皮片全部成活。所有患者均进入术后3至18个月的随访期。皮瓣的形状质地良好，不臃肿。皮瓣的感觉部分恢复。在最后一次随访中，根据美国足踝矫形学会（AOFAS）中足评分标准对8个皮瓣进行了评估。结果优5例，良2例，差1例，优良率87.5%。它具有可靠的皮瓣血液供应和相对简单的手术程序。关键词：跗外侧动脉穿支皮瓣；前支；前脚；修理

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来源期刊

中华显微外科杂志

CiteScore

0.50

自引率

0.00%

发文量

6448

期刊介绍： Chinese Journal of Microsurgery was established in 1978, the predecessor of which is Microsurgery. Chinese Journal of Microsurgery is now indexed by WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 1.731 in 2017, ranking the third among all journal of comprehensive surgery. The journal covers clinical and basic studies in field of microsurgery. Articles with clinical interest and implications will be given preference.