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.	魏在荣, 邵星, 谢月, 等.腓肠肌内侧头穿支皮瓣修复腘窝瘢痕创面.中华烧伤杂志, 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.	张华星, 邵新中, 杨晓亮, 等.腓肠外侧动脉穿支与腓肠外侧皮神经营养血管联合蒂肌皮瓣的临床应用.中华显微外科杂志, 2012, 35(6):464-466.
4.	李早光, 徐静, 张莉, 等.小隐静脉-腓肠外侧神经蒂逆行皮瓣解剖及临床应用研究.中华显微外科杂志, 2006, 29(2):81-83.
5.	陈胜华, 谭建国, 唐茂林, 等.腓肠外侧皮神经营养血管岛状筋膜皮瓣的解剖学基础.中国临床解剖学杂志, 2004, 22(1):22-25.
6.	张世民, 徐达传, 顾玉东, 等.链型皮瓣的血管基础及临床意义.中国临床解剖学杂志, 2004, 22(1):13-16.
7.	魏在荣.皮瓣命名方式探讨.中华损伤与修复杂志(电子版), 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.	魏在荣, 孙广峰, 唐修俊, 等.胫后动脉穿支蒂小腿内后侧网状供血皮瓣修复足踝部巨大创面.中华创伤杂志, 2010, 26(8):734-736.
11.	钟世镇, 徐永清, 周长满.皮神经营养血管皮瓣解剖基础及命名.中华显微外科杂志, 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, 张莉, 等.腓肠外侧神经-小隐静脉血管蒂皮瓣的解剖学观察与临床应用.中华医学美学美容杂志, 2013, 19(1):24-26.
15.	黎晓华, 陈实, 李峻, 等.保留腓肠神经的血管筋膜蒂皮瓣的解剖及临床研究.中华显微外科杂志, 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.	魏在荣, 孙广峰, 唐修俊, 等.腘窝中间动脉蒂混合供血皮瓣修复儿童腘窝瘢痕挛缩.中国修复重建外科杂志, 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. 魏在荣, 邵星, 谢月, 等.腓肠肌内侧头穿支皮瓣修复腘窝瘢痕创面.中华烧伤杂志, 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. 张华星, 邵新中, 杨晓亮, 等.腓肠外侧动脉穿支与腓肠外侧皮神经营养血管联合蒂肌皮瓣的临床应用.中华显微外科杂志, 2012, 35(6):464-466.
4. 李早光, 徐静, 张莉, 等.小隐静脉-腓肠外侧神经蒂逆行皮瓣解剖及临床应用研究.中华显微外科杂志, 2006, 29(2):81-83.
5. 陈胜华, 谭建国, 唐茂林, 等.腓肠外侧皮神经营养血管岛状筋膜皮瓣的解剖学基础.中国临床解剖学杂志, 2004, 22(1):22-25.
6. 张世民, 徐达传, 顾玉东, 等.链型皮瓣的血管基础及临床意义.中国临床解剖学杂志, 2004, 22(1):13-16.
7. 魏在荣.皮瓣命名方式探讨.中华损伤与修复杂志(电子版), 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. 魏在荣, 孙广峰, 唐修俊, 等.胫后动脉穿支蒂小腿内后侧网状供血皮瓣修复足踝部巨大创面.中华创伤杂志, 2010, 26(8):734-736.
11. 钟世镇, 徐永清, 周长满.皮神经营养血管皮瓣解剖基础及命名.中华显微外科杂志, 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, 张莉, 等.腓肠外侧神经-小隐静脉血管蒂皮瓣的解剖学观察与临床应用.中华医学美学美容杂志, 2013, 19(1):24-26.
15. 黎晓华, 陈实, 李峻, 等.保留腓肠神经的血管筋膜蒂皮瓣的解剖及临床研究.中华显微外科杂志, 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. 魏在荣, 孙广峰, 唐修俊, 等.腘窝中间动脉蒂混合供血皮瓣修复儿童腘窝瘢痕挛缩.中国修复重建外科杂志, 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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