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首页> 外文期刊>Injury >Versatility of the sural fasciocutaneous flap in coverage defects of the lower limb.
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Versatility of the sural fasciocutaneous flap in coverage defects of the lower limb.

机译：腓肠肌筋膜皮瓣在下肢覆盖缺损中的多功能性。

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We present in this work, our experience with the sural fasciocutaneous flap to treat coverage defects following a lower limb posttraumatic lesion. This paper is a review of these flaps carried out in different centres between 2000 and 2005. The series consists of 14 patients, 12 men and 2 women with an average age of 38 years (23-54) and with a medium follow-up time of 2 years (12-48 months). In all of the cases, aetiology was a lower limb injury or its complications, most frequently a distal tibial fracture (eight patients), followed by sequelae from Achilles tendon reconstruction (two patients), fracture of the calcaneus (two patients) and osteomyelitis of the distal tibia secondary to an open fracture (two patients). Associated risk factors in the patients for performing the flap were diabetes (one case) and cigarette smoking (four cases). The technique is based on the use of a reverse-flow island sural flap with the superficial sural artery dependent on perforators of the peroneal arterial system. The anatomical structures which constitute the pedicle are the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The flap was viable in 13 of 14 patients. Only one flap failed in, a diabetic patient. No patient showed signs of infection. Slight venous congestion of the flap occurred in two cases. No further surgical intervention of the donor site was required. In two cases partial necrosis of the skin edges occurred which resolved satisfactorily with conservative treatment. The sural fasciocutaneous flap is useful for the treatment of complex injuries of the lower limbs and their complications. Its technical advantages are: easy dissection with preservation of more important vascular structures in the limb, complete coverage of the soft tissue defect in just one operation without the need of microsurgical anastomosis. All this results in a well vascularised cutaneous islet and thus a reliable flap.
机译：我们在这项工作中介绍了我们使用腓肠肌筋膜皮瓣治疗下肢创伤后病变后的覆盖缺陷的经验。本文是对2000年至2005年在不同中心进行的皮瓣的回顾。该系列由14例患者组成，其中12例男性和2例女性，平均年龄38岁（23-54岁），随访时间中等2年（12-48个月）。在所有情况下，病因都是下肢损伤或其并发症，最常见的是胫骨远端骨折（8例），然后是跟腱重建的后遗症（2例），跟骨骨折（2例）和骨髓炎。胫骨远端继发于开放性骨折（两名患者）。发生皮瓣的患者的相关危险因素为糖尿病（1例）和吸烟（4例）。该技术基于使用逆流岛式腓肠瓣，其中腓浅动脉依赖于腓动脉系统的穿支孔。构成椎弓根的解剖结构是浅表和深筋膜，腓肠神经，短隐静脉，腓肠浅动脉以及皮下细胞组织和皮肤胰岛。皮瓣在14例患者中有13例可行。一名糖尿病患者只有一个皮瓣失败。没有患者显示出感染迹象。皮瓣有轻微的静脉充血2例。无需对供体部位进行进一步的手术干预。在两种情况下，发生了皮肤边缘的部分坏死，通过保守治疗可以令人满意地解决。腓肠肌筋膜皮瓣可用于治疗下肢的复杂损伤及其并发症。它的技术优势是：易于解剖并保留了肢体中更重要的血管结构，仅需一次手术即可完全覆盖软组织缺损，而无需进行显微外科手术吻合。所有这些导致血管化良好的皮肤胰岛，并因此产生可靠的皮瓣。

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