TREATMENT OF LEG, FOOT, AND ANKLE WOUNDS WITH SAPHENOUS NEUROCUTANEOUS VASCULAR FLAPS COMBINED WITH ASSEMBLY EXTERNAL FRISKET FOR FIXATION IN PARALLEL-LEG POSITION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LIZelong , HUANBin , LIUXibin , CHENQinzhou , CAIXiwei , ZHENGYongjia

No.1. Department of Orthopedics, the 188 th Hospital of Chinese PLA, Chaozhou Guangdong, 521000, P. R. China;

Corresponding?author：

LIZelong, Email: gdlzl188@163.com

Keywords：

Leg wound; Foot and ankle wounds; Saphenous neurocutaneous vascular flap; Assembly external frisket; Fixation in parallel-leg position; Wound repair

DOI：

10.7507/1002-1892.20140273

Video：

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Objective To explore the effectiveness of a new method to repair severe soft tissue defects of the leg, foot, and ankle with contralateral saphenous neurocutaneous vascular flaps combined with assembly external frisket for fixation in parallel-leg position. Methods Between August 2009 and August 2013, 29 cases with leg, foot, or ankle wound were treated. There were 18 males and 11 females, with an average age of 37.6 years (range, 11-65 years). The interval of injury and operation was 14-36 days (mean, 22.3 days). The locations were the planta pedis and heel in 5 cases, the dorsal foot in 2 cases, the ankle in 4 cases, middle and lower leg in 14 cases, and upper leg in 4 cases. The area of trauma ranged from 5 cm×3 cm to 19 cm×9 cm. The assembly external frisket was used for fixation in parallel-leg position; a bridge flap was transplanted to repair defects, and the area of flap ranged from 6 cm×4 cm to 22 cm×11 cm. The donor sites were directly sutured or repaired with skin graft. The pedicle of the bridge flap was cut off and the assembly external frisket was removed after 3-4 weeks. Results The flaps in all patients survived completely; primary healing of wound and incision at donor site was obtained. The patients were followed up 6-18 months (mean, 13.2 months). The appearance of flaps was satisfactory, and the sensation of the heel recovered. Moreover, the patients had a comfortable feeling, and the ankle and knee joints can move freely, and had good function. Conclusion The assembly external frisket in parallel-leg position instead of cross-leg can make patients comfortable position, and achieve reliable fixation. The saphenous neurocutaneous vascular flap has the advantages of no need for anastomosis vein and for sacrifice of the main vein. Contralateral saphenous neurocutaneous vascular flap combined with assembly external frisket for fixation in parallel-leg position is a favorite method to repair severe soft tissue defects of the leg, foot, and ankle.

Citation： LIZelong, HUANBin, LIUXibin, CHENQinzhou, CAIXiwei, ZHENGYongjia. TREATMENT OF LEG, FOOT, AND ANKLE WOUNDS WITH SAPHENOUS NEUROCUTANEOUS VASCULAR FLAPS COMBINED WITH ASSEMBLY EXTERNAL FRISKET FOR FIXATION IN PARALLEL-LEG POSITION. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(10): 1263-1265. doi: 10.7507/1002-1892.20140273 Copy

1.	鄭磊, 董忠根, 鄭稼, 等.腓動脈穿支筋膜蒂腓腸神經營養血管皮瓣修復足背皮膚軟組織缺損.中國修復重建外科雜志, 2011, 25(4):427-430.
2.	陳武, 黎忠文, 袁華軍.小腿及足部開放性骨折合并皮膚缺損的皮瓣修復.中華顯微外科雜志, 2013, 36(5):505-506.
3.	楊科躍, 周丹亞, 潘佳棟, 等.游離穿支皮瓣在老年患者四肢皮膚缺損中的應用.中華顯微外科雜志, 2014, 37(1):17-21.
4.	葉吉忠, 柴益民, 陸男吉, 等.帶隱神經營養血管皮瓣交腿筋膜皮瓣修復小腿創傷性骨外露創面.中華顯微外科雜志, 2007, 30(4):297-299.
5.	趙志堅, 陳坤峰, 張傳林, 等.應用外固定架結合皮瓣移植治療脛腓骨開放性骨折創面.中華顯微外科雜志, 2013, 36(5):507-508.
6.	李澤龍, 黃賓, 蔡習煒, 等.小腿淺靜脈皮神經皮瓣修復足遠端創面.實用骨科雜志, 2010, 16(7):541-543.
7.	陳輝, 陳紹宗.端側神經吻合恢復隱神經營養血管蒂逆行皮瓣感覺的應用.中華顯微外科雜志, 2002, 25(1):54-55.
8.	Atiyeh BS, Al-Amm CA, El-Musa KA, et al.Distally based sural fasciocutaneous cross-leg flap:a new application of an old procedure.Plast Reconstr Surg, 2003, 111(4):1470-1474.
9.	于仲嘉, 曾炳芳, 何鶴皋.橋式交叉吻合血管游離組織移植.中華骨科雜志, 1994, 14(6):332-334.
10.	胡孔和, 吳強, 靳安民, 等.神經端側吻合重建游離皮瓣感覺功能的臨床效果.中華顯微外科雜志, 2012, 35(3):237-239.
11.	趙琳, 萬麟, 王栓科.克氏針簡單內固定改良交腿皮瓣術后交腿體位維持的臨床效果分析.中國修復重建外科雜志, 2006, 20(12):1211-1213.
12.	杜海龍, 何純青, 柳現飛, 等.外固定支架結合負壓封閉引流技術治療GustiloⅢ型脛腓骨開放性骨折.中華創傷骨科雜志, 2011, 13(5):433-436.
13.	龔偉華, 朱振安, 孫月華.脛腓骨開放性骨折的分期治療.國外醫學:骨科分冊, 2004, 25(4):220-222.
14.	張建河, 武進華, 馮志彬, 等.單側三維外固定支架治療脛骨GustiloⅢ型骨折.實用骨科雜志, 2005, 11(1):85-86.
15.	Serkan Y, Mitha A, Kaan G, et al.Use of distally based saphenous neurofasciocutaneous and musculofasciocutaneous cross-leg flaps in limb salvag.Ann Plast Surg, 2001, 47(5):568-574.

1. 鄭磊, 董忠根, 鄭稼, 等.腓動脈穿支筋膜蒂腓腸神經營養血管皮瓣修復足背皮膚軟組織缺損.中國修復重建外科雜志, 2011, 25(4):427-430.
2. 陳武, 黎忠文, 袁華軍.小腿及足部開放性骨折合并皮膚缺損的皮瓣修復.中華顯微外科雜志, 2013, 36(5):505-506.
3. 楊科躍, 周丹亞, 潘佳棟, 等.游離穿支皮瓣在老年患者四肢皮膚缺損中的應用.中華顯微外科雜志, 2014, 37(1):17-21.
4. 葉吉忠, 柴益民, 陸男吉, 等.帶隱神經營養血管皮瓣交腿筋膜皮瓣修復小腿創傷性骨外露創面.中華顯微外科雜志, 2007, 30(4):297-299.
5. 趙志堅, 陳坤峰, 張傳林, 等.應用外固定架結合皮瓣移植治療脛腓骨開放性骨折創面.中華顯微外科雜志, 2013, 36(5):507-508.
6. 李澤龍, 黃賓, 蔡習煒, 等.小腿淺靜脈皮神經皮瓣修復足遠端創面.實用骨科雜志, 2010, 16(7):541-543.
7. 陳輝, 陳紹宗.端側神經吻合恢復隱神經營養血管蒂逆行皮瓣感覺的應用.中華顯微外科雜志, 2002, 25(1):54-55.
8. Atiyeh BS, Al-Amm CA, El-Musa KA, et al.Distally based sural fasciocutaneous cross-leg flap:a new application of an old procedure.Plast Reconstr Surg, 2003, 111(4):1470-1474.
9. 于仲嘉, 曾炳芳, 何鶴皋.橋式交叉吻合血管游離組織移植.中華骨科雜志, 1994, 14(6):332-334.
10. 胡孔和, 吳強, 靳安民, 等.神經端側吻合重建游離皮瓣感覺功能的臨床效果.中華顯微外科雜志, 2012, 35(3):237-239.
11. 趙琳, 萬麟, 王栓科.克氏針簡單內固定改良交腿皮瓣術后交腿體位維持的臨床效果分析.中國修復重建外科雜志, 2006, 20(12):1211-1213.
12. 杜海龍, 何純青, 柳現飛, 等.外固定支架結合負壓封閉引流技術治療GustiloⅢ型脛腓骨開放性骨折.中華創傷骨科雜志, 2011, 13(5):433-436.
13. 龔偉華, 朱振安, 孫月華.脛腓骨開放性骨折的分期治療.國外醫學:骨科分冊, 2004, 25(4):220-222.
14. 張建河, 武進華, 馮志彬, 等.單側三維外固定支架治療脛骨GustiloⅢ型骨折.實用骨科雜志, 2005, 11(1):85-86.
15. Serkan Y, Mitha A, Kaan G, et al.Use of distally based saphenous neurofasciocutaneous and musculofasciocutaneous cross-leg flaps in limb salvag.Ann Plast Surg, 2001, 47(5):568-574.

Chinese Journal of Reparative and Reconstructive Surgery

TREATMENT OF LEG, FOOT, AND ANKLE WOUNDS WITH SAPHENOUS NEUROCUTANEOUS VASCULAR FLAPS COMBINED WITH ASSEMBLY EXTERNAL FRISKET FOR FIXATION IN PARALLEL-LEG POSITION

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