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

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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.	郑磊, 董忠根, 郑稼, 等.腓动脉穿支筋膜蒂腓肠神经营养血管皮瓣修复足背皮肤软组织缺损.中国修复重建外科杂志, 2011, 25(4):427-430.
2.	陈武, 黎忠文, 袁华军.小腿及足部开放性骨折合并皮肤缺损的皮瓣修复.中华显微外科杂志, 2013, 36(5):505-506.
3.	杨科跃, 周丹亚, 潘佳栋, 等.游离穿支皮瓣在老年患者四肢皮肤缺损中的应用.中华显微外科杂志, 2014, 37(1):17-21.
4.	叶吉忠, 柴益民, 陆男吉, 等.带隐神经营养血管皮瓣交腿筋膜皮瓣修复小腿创伤性骨外露创面.中华显微外科杂志, 2007, 30(4):297-299.
5.	赵志坚, 陈坤峰, 张传林, 等.应用外固定架结合皮瓣移植治疗胫腓骨开放性骨折创面.中华显微外科杂志, 2013, 36(5):507-508.
6.	李泽龙, 黄宾, 蔡习炜, 等.小腿浅静脉皮神经皮瓣修复足远端创面.实用骨科杂志, 2010, 16(7):541-543.
7.	陈辉, 陈绍宗.端侧神经吻合恢复隐神经营养血管蒂逆行皮瓣感觉的应用.中华显微外科杂志, 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, 何鹤皋.桥式交叉吻合血管游离组织移植.中华骨科杂志, 1994, 14(6):332-334.
10.	胡孔和, 吴强, 靳安民, 等.神经端侧吻合重建游离皮瓣感觉功能的临床效果.中华显微外科杂志, 2012, 35(3):237-239.
11.	赵琳, 万麟, 王栓科.克氏针简单内固定改良交腿皮瓣术后交腿体位维持的临床效果分析.中国修复重建外科杂志, 2006, 20(12):1211-1213.
12.	杜海龙, 何纯青, 柳现飞, 等.外固定支架结合负压封闭引流技术治疗GustiloⅢ型胫腓骨开放性骨折.中华创伤骨科杂志, 2011, 13(5):433-436.
13.	龚伟华, 朱振安, 孙月华.胫腓骨开放性骨折的分期治疗.国外医学:骨科分册, 2004, 25(4):220-222.
14.	张建河, 武进华, 冯志彬, 等.单侧三维外固定支架治疗胫骨GustiloⅢ型骨折.实用骨科杂志, 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. 郑磊, 董忠根, 郑稼, 等.腓动脉穿支筋膜蒂腓肠神经营养血管皮瓣修复足背皮肤软组织缺损.中国修复重建外科杂志, 2011, 25(4):427-430.
2. 陈武, 黎忠文, 袁华军.小腿及足部开放性骨折合并皮肤缺损的皮瓣修复.中华显微外科杂志, 2013, 36(5):505-506.
3. 杨科跃, 周丹亚, 潘佳栋, 等.游离穿支皮瓣在老年患者四肢皮肤缺损中的应用.中华显微外科杂志, 2014, 37(1):17-21.
4. 叶吉忠, 柴益民, 陆男吉, 等.带隐神经营养血管皮瓣交腿筋膜皮瓣修复小腿创伤性骨外露创面.中华显微外科杂志, 2007, 30(4):297-299.
5. 赵志坚, 陈坤峰, 张传林, 等.应用外固定架结合皮瓣移植治疗胫腓骨开放性骨折创面.中华显微外科杂志, 2013, 36(5):507-508.
6. 李泽龙, 黄宾, 蔡习炜, 等.小腿浅静脉皮神经皮瓣修复足远端创面.实用骨科杂志, 2010, 16(7):541-543.
7. 陈辉, 陈绍宗.端侧神经吻合恢复隐神经营养血管蒂逆行皮瓣感觉的应用.中华显微外科杂志, 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, 何鹤皋.桥式交叉吻合血管游离组织移植.中华骨科杂志, 1994, 14(6):332-334.
10. 胡孔和, 吴强, 靳安民, 等.神经端侧吻合重建游离皮瓣感觉功能的临床效果.中华显微外科杂志, 2012, 35(3):237-239.
11. 赵琳, 万麟, 王栓科.克氏针简单内固定改良交腿皮瓣术后交腿体位维持的临床效果分析.中国修复重建外科杂志, 2006, 20(12):1211-1213.
12. 杜海龙, 何纯青, 柳现飞, 等.外固定支架结合负压封闭引流技术治疗GustiloⅢ型胫腓骨开放性骨折.中华创伤骨科杂志, 2011, 13(5):433-436.
13. 龚伟华, 朱振安, 孙月华.胫腓骨开放性骨折的分期治疗.国外医学:骨科分册, 2004, 25(4):220-222.
14. 张建河, 武进华, 冯志彬, 等.单侧三维外固定支架治疗胫骨GustiloⅢ型骨折.实用骨科杂志, 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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