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首页> 外文期刊>The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons >Foot and Ankle Reconstruction Using the Distally Based Sural Artery Flap Versus the Medial Plantar Flap: A Comparative Study
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Foot and Ankle Reconstruction Using the Distally Based Sural Artery Flap Versus the Medial Plantar Flap: A Comparative Study

机译：使用远端的血管动脉瓣与内侧跖翼的脚和脚踝重建：比较研究

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摘要

Soft tissue defects around the foot and ankle region often present an awkward problem for plastic surgeons. The medial plantar artery flap raised from the non-weightbearing instep of the plantar foot offers a thick, sensorial, durable, and glabrous skin. The reversed sural artery flap offers a reliable option for coverage with the advantages of a wide arc of rotation, adequate dimensions, and a reliable blood supply. The present study compared the outcomes of the medial plantar artery flap and the distally based sural artery flap in foot and ankle reconstruction. The present comparative cross-sectional study included 30 adult patients with soft tissue defects in the foot and around the ankle, who were divided into 2 equal groups. One group underwent reconstruction with the proximally based island medial plantar artery flap (MPAF). The second group underwent reconstruction with the reversed sural artery flap (RSAF). The operative time and complications were carefully recorded. The surgical outcomes in terms of flap survival, durability of coverage, and functional outcome were assessed for all patients. No significant differences were found between the 2 groups in age, sex, etiology, or site of the defect. The defect size was significantly smaller in the MPAF group than in the RSAF group (22 +/- 2.7 cm(2) versus 66.2 +/- 7.7 cm2; p <.001). However, the operative time was significantly longer in the MPAF group than in the RSAF group (100 +/- 2.9 minutes versus 80.5 +/- 3.1 minutes; p <.001). The flap survived in all cases in the MPAF group, but total flap necrosis occurred in 1 patient in the RSAF group. The mean follow-up period was 13.2 months. weightbearing was significantly earlier in the MPAF group than in the RSAF group (5.8 +/- 0.26 weeks versus 6.9 +/- 0.19 weeks; p =.003). None of the 30 patients developed recurrent ulceration. The incidence of complications (33.3% versus 80%) was significantly less in the MPAF group than in the RSAF group (p =.01). Significantly greater improvement was found in the functional outcomes in the MPAF group compared with the RSAF group (p =.004). In conclusion, the MPAF and distally based sural artery flap are the 2 flaps available for foot and ankle reconstruction. However, the MPAF offers better functional outcomes with a lower frequency of postoperative complications. Thus, the sensate MPAF is recommended for reconstruction of moderate-size defects of the foot and ankle region. (C) 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
机译：脚和踝部区域周围的软组织缺陷通常为整体外科医生呈现一个尴尬的问题。从跖脚的非衔接脚背上提出的内侧跖部动脉瓣提供厚，感觉，耐用和无毛皮肤。逆转的血管动脉瓣提供可靠的选择，可覆盖宽弧，适当尺寸和可靠的血液供应。本研究比较了内侧跖翼动脉瓣的结果和脚踝重建的远端血管动脉瓣。本发明的比较横截面研究包括30名成年患者在脚下和踝部周围的软组织缺陷，踝部分为2个相等的群体。一组与近端岛内侧跖跖动脉瓣（MPAF）接受重建。第二组与逆转的血管动脉瓣（RSAF）接受重建。仔细记录手术时间和并发症。所有患者都会评估瓣膜存活率，覆盖耐久性和功能结果方面的手术结果。在年龄，性别，病因或缺陷现场的2组之间没有发现显着差异。 MPAF组的缺陷尺寸明显较小，而不是RSAF组（22 +/- 2.7 cm（2），而66.2 +/- 7.7 cm2; p <.001）。然而，在MPAF组中的操作时间比RSAF组在MPAF组中（100 +/- 2.9分钟为80.5 +/- 3.1分钟; P <.001）。皮瓣在MPAF组的所有病例中存活，但在RSAF组中的1例患者中发生了总皮瓣坏死。平均随访时间为13.2个月。 MPAF组的举重显着比在RSAF组中显着（5.8 +/- 0.26周，与6.9 +/- 0.19周; p = .003）。 30名患者中没有一个产生复发性溃疡。 MPAF组在MPAF组中的并发症发生率（33.3％对80％）显着较低（P = .01）。与RSAF组相比，MPAF组的功能结果发现有明显更大的改善（P = .004）。总之，MPAF和远端血管动脉瓣是可用于足部和脚踝重建的2个襟翼。但是，MPAF提供更好的功能性结果，术后并发症的较低频率。因此，建议对脚和脚踝区域的中等尺寸缺陷的重建来改造感觉MPAF。 （c）2017由美国脚和踝外科医院。版权所有。

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