CLINICAL APPLICATION OF LINK-PATTERN LATERAL POPLITEAL ARTERY PERFORATOR FLAP IN REPAIR OF POPLITEAL FOSSA SCAR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TANGXiujun , WANGBaoyun ,  WEIZairong , SUNGuangfeng , WANGBo , JINWenhu , WANGDali

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003, P. R. China;

Corresponding?author：

WEIZairong, Email: zairongwei@sina.com

Keywords：

Link-pattern lateral popliteal artery perforator flap; Scar contracture; Wound repair

DOI：

10.7507/1002-1892.20140272

Video：

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Objective To discuss the feasibility and effectiveness of link-pattern lateral popliteal artery perforator flap in repairing popliteal fossa scar contracture in children or teenagers. Methods Between January 2009 and January 2013, 12 patients with popliteal fossa scar were admitted. Of them, 7 cases were male and 5 cases were female, aged from 3 to 17 years (median, 12 years). The disease duration was from 6 months to 5 years (median, 3 years). Wound was repaired with link-pattern lateral popliteal artery perforator flap after remission of popliteal fossa scar. The wound ranged from 6 cm×4 cm to 10 cm×7 cm, and the flap size ranged from 7 cm×4 cm to 12 cm×9 cm. The flap was with lateral sural cutaneous nerve in 5 cases, and lateral sural cutaneous nerve was retained at the donor area of 7 cases. The donor site was repaired using split-thickness skin graft. Results All pedicled flaps and skin graft survived smoothly after operation. The wound at donor site healed by first intention. All the cases were followed up 12-36 months, with an average of 18 months. The flaps had good color, texture, and shape; scar obviously became softened, without hyperplasia or ulceration. The patients were free from lameness with knee range of motion of 0-180°. The squatting function was normal. Grafting skin was smooth in the donor area of the calf, without depression or scar hyperplasia. The senses of posterior-inferior calf and lateral of foot decreased or disappeared in 5 cases of flaps with lateral sural cutaneous nerve; at 6 months after operation, two-point discrimination was 12-14 mm (mean, 13 mm). The posterior-inferior calf was numb and discomfort in 7 cases of flaps with retained lateral sural cutaneous nerve; but after 3-6 months, the sense was obviously recovered, with no sense loss; at 6 months after operation, two-point discrimination was 5-7 mm (mean, 6 mm). Conclusion Link-pattern lateral popliteal artery perforator flap has reliable blood supply and the operation was simple. The cutaneous nerve can be retained in donor area. It is an ideal method for repairing wound after remission of popliteal fossa scar in children or teenagers.

Citation： TANGXiujun, WANGBaoyun, WEIZairong, SUNGuangfeng, WANGBo, JINWenhu, WANGDali. CLINICAL APPLICATION OF LINK-PATTERN LATERAL POPLITEAL ARTERY PERFORATOR FLAP IN REPAIR OF POPLITEAL FOSSA SCAR. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(10): 1259-1262. doi: 10.7507/1002-1892.20140272 Copy

1.	魏在榮, 邵星, 謝月, 等.腓腸肌內側頭穿支皮瓣修復腘窩瘢痕創面.中華燒傷雜志, 2010, 26(4):260-262.
2.	Wiedner M, Koch H, Scharnagl E.The superior lateral genicular artery flap for soft-tissue reconstruction around the knee:clinical experience and review of the literature.Ann Plast Surg, 2011, 66(4):388-392.
3.	張華星, 邵新中, 楊曉亮, 等.腓腸外側動脈穿支與腓腸外側皮神經營養血管聯合蒂肌皮瓣的臨床應用.中華顯微外科雜志, 2012, 35(6):464-466.
4.	李早光, 徐靜, 張莉, 等.小隱靜脈-腓腸外側神經蒂逆行皮瓣解剖及臨床應用研究.中華顯微外科雜志, 2006, 29(2):81-83.
5.	陳勝華, 譚建國, 唐茂林, 等.腓腸外側皮神經營養血管島狀筋膜皮瓣的解剖學基礎.中國臨床解剖學雜志, 2004, 22(1):22-25.
6.	張世民, 徐達傳, 顧玉東, 等.鏈型皮瓣的血管基礎及臨床意義.中國臨床解剖學雜志, 2004, 22(1):13-16.
7.	魏在榮.皮瓣命名方式探討.中華損傷與修復雜志(電子版), 2011, 6(3):337-341.
8.	Saint-Cyr M, Wong C, Schaverien M, et al.The perforasome theory:Vascular anatomy and clinical implications.Plast Reconstr Surg, 2009, 124(5):1529-1544.
9.	Lecours C, Saint-Cyr M, Wong C, et al.Freestyle pedicle perforator flaps:clinical results and vascular anatomy.Plast Reconstr Surg, 2010, 126(5):1589-1603.
10.	魏在榮, 孫廣峰, 唐修俊, 等.脛后動脈穿支蒂小腿內后側網狀供血皮瓣修復足踝部巨大創面.中華創傷雜志, 2010, 26(8):734-736.
11.	鐘世鎮, 徐永清, 周長滿.皮神經營養血管皮瓣解剖基礎及命名.中華顯微外科雜志, 1999, 22(1):37-39.
12.	Nakajima H, Imanishi N, Fukuzumi S, et al.Accompanying arteries of the lesser saphenous vein and sural nerve:anatomic strdy and its clinical applications.Plast Reconstr Surg, 1999, 103(1):104-120.
13.	Mojallal A, Wong C, Shipkov C, et al.Vascular supply of the distally based superficial sural artery flap:surgical safe zones based on component analysis using three-dimensional computed tomographic angiography.Plast Reconstr Surg, 2010, 126(4):1240-1252.
14.	熊竹友, 李光早, 張莉, 等.腓腸外側神經-小隱靜脈血管蒂皮瓣的解剖學觀察與臨床應用.中華醫學美學美容雜志, 2013, 19(1):24-26.
15.	黎曉華, 陳實, 李峻, 等.保留腓腸神經的血管筋膜蒂皮瓣的解剖及臨床研究.中華顯微外科雜志, 2008, 31(6):401-404.
16.	Yao Y, Liu Y, Zhou J, et al.The epidemiology of civilian inpatients' burns in Chinese military hospitals, 2001-2007.Burns, 2011, 37(6):1023-1032.
17.	魏在榮, 孫廣峰, 唐修俊, 等.腘窩中間動脈蒂混合供血皮瓣修復兒童腘窩瘢痕攣縮.中國修復重建外科雜志, 2012, 26(8):946-949.
18.	Koymen R, Gulses A, Karakayli U, et al.Treatment of microstomia with commissuroplasties and semidynamic acrylic splints.Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(4):503-507.

1. 魏在榮, 邵星, 謝月, 等.腓腸肌內側頭穿支皮瓣修復腘窩瘢痕創面.中華燒傷雜志, 2010, 26(4):260-262.
2. Wiedner M, Koch H, Scharnagl E.The superior lateral genicular artery flap for soft-tissue reconstruction around the knee:clinical experience and review of the literature.Ann Plast Surg, 2011, 66(4):388-392.
3. 張華星, 邵新中, 楊曉亮, 等.腓腸外側動脈穿支與腓腸外側皮神經營養血管聯合蒂肌皮瓣的臨床應用.中華顯微外科雜志, 2012, 35(6):464-466.
4. 李早光, 徐靜, 張莉, 等.小隱靜脈-腓腸外側神經蒂逆行皮瓣解剖及臨床應用研究.中華顯微外科雜志, 2006, 29(2):81-83.
5. 陳勝華, 譚建國, 唐茂林, 等.腓腸外側皮神經營養血管島狀筋膜皮瓣的解剖學基礎.中國臨床解剖學雜志, 2004, 22(1):22-25.
6. 張世民, 徐達傳, 顧玉東, 等.鏈型皮瓣的血管基礎及臨床意義.中國臨床解剖學雜志, 2004, 22(1):13-16.
7. 魏在榮.皮瓣命名方式探討.中華損傷與修復雜志(電子版), 2011, 6(3):337-341.
8. Saint-Cyr M, Wong C, Schaverien M, et al.The perforasome theory:Vascular anatomy and clinical implications.Plast Reconstr Surg, 2009, 124(5):1529-1544.
9. Lecours C, Saint-Cyr M, Wong C, et al.Freestyle pedicle perforator flaps:clinical results and vascular anatomy.Plast Reconstr Surg, 2010, 126(5):1589-1603.
10. 魏在榮, 孫廣峰, 唐修俊, 等.脛后動脈穿支蒂小腿內后側網狀供血皮瓣修復足踝部巨大創面.中華創傷雜志, 2010, 26(8):734-736.
11. 鐘世鎮, 徐永清, 周長滿.皮神經營養血管皮瓣解剖基礎及命名.中華顯微外科雜志, 1999, 22(1):37-39.
12. Nakajima H, Imanishi N, Fukuzumi S, et al.Accompanying arteries of the lesser saphenous vein and sural nerve:anatomic strdy and its clinical applications.Plast Reconstr Surg, 1999, 103(1):104-120.
13. Mojallal A, Wong C, Shipkov C, et al.Vascular supply of the distally based superficial sural artery flap:surgical safe zones based on component analysis using three-dimensional computed tomographic angiography.Plast Reconstr Surg, 2010, 126(4):1240-1252.
14. 熊竹友, 李光早, 張莉, 等.腓腸外側神經-小隱靜脈血管蒂皮瓣的解剖學觀察與臨床應用.中華醫學美學美容雜志, 2013, 19(1):24-26.
15. 黎曉華, 陳實, 李峻, 等.保留腓腸神經的血管筋膜蒂皮瓣的解剖及臨床研究.中華顯微外科雜志, 2008, 31(6):401-404.
16. Yao Y, Liu Y, Zhou J, et al.The epidemiology of civilian inpatients' burns in Chinese military hospitals, 2001-2007.Burns, 2011, 37(6):1023-1032.
17. 魏在榮, 孫廣峰, 唐修俊, 等.腘窩中間動脈蒂混合供血皮瓣修復兒童腘窩瘢痕攣縮.中國修復重建外科雜志, 2012, 26(8):946-949.
18. Koymen R, Gulses A, Karakayli U, et al.Treatment of microstomia with commissuroplasties and semidynamic acrylic splints.Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(4):503-507.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL APPLICATION OF LINK-PATTERN LATERAL POPLITEAL ARTERY PERFORATOR FLAP IN REPAIR OF POPLITEAL FOSSA SCAR

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