APPLICATION OF V-Y ADVANCED SENSE-REMAINED POSTERIOR TIBIAL ARTERY PERFORATOR FLAP IN REPAIRING WOUND AROUND ANKLE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 TANGXiujun , WANGBo , WEIZairong , WANGDali , HANWenjie , ZHANGWenduo , LIShujun

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003, P. R. China;

Corresponding author：

TANGXiujun, Email: xiujunsszx@163.com

Keywords：

Ankle wound; Posterior tibial artery perforator; V-Y advanced flap; Wound repair

DOI：

10.7507/1002-1892.20150324

Video：

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Objective To explore the feasibility and effectiveness of V-Y advanced sense-remained posterior tibial artery perforator flap in repairing wound around the ankle. Methods Between March 2012 and January 2015, 11 patients with wounds around the ankle were treated by V-Y advanced sense-remained posterior tibial artery perforator flap. There were 6 males and 5 females with a median age of 37 years (range, 21-56 years). The causes were traffic accident injury in 3 cases, thermal injury in 2 cases, burn in 2 cases, iatrogenic wounds in 2 cases, and local contusion in 2 cases. The disease duration ranged from 1 to 3 weeks (mean, 2 weeks). Injury was located at the medial malleolus in 4 cases, at the lateral malleolus in 3 cases, and at the heel in 4 cases. All had exposure of bone, tendon, or plate. The defect area ranged from 4 cm×2 cm to 5 cm×3 cm; the area of the flap ranged from 11 cm×4 cm to 15 cm×6 cm. Results Necrosis of distal flap occurred in 1 case after operation; re-operation to amputate the posterior tibial artery was given and the wound was repaired by proximal skin graft. Light necrosis of distal end was observed in 2 cases, and wound healed at 3 weeks after dressing. And other flaps successfully survived, and primary healing of wounds were obtained. The patients were followed up 6-24 months (mean, 11 months). The flaps were good in color, texture, and appearance. The ankle joint had normal activity. At last follow-up, 10 cases restored fine sense, and 1 case restored protective feeling with posterior tibial artery advanced flap after amputation. Conclusion V-Y advanced sense-remained posterior tibial artery perforator flap has the advantages of reliable blood supply, simple operation, good appearance, and sensory recovery. Therefore, it is an ideal method to repair wound around the ankle.

Citation： TANGXiujun, WANGBo, WEIZairong, WANGDali, HANWenjie, ZHANGWenduo, LIShujun. APPLICATION OF V-Y ADVANCED SENSE-REMAINED POSTERIOR TIBIAL ARTERY PERFORATOR FLAP IN REPAIRING WOUND AROUND ANKLE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(12): 1515-1518. doi: 10.7507/1002-1892.20150324 Copy

1.	周晓, 薛明宇, 强力, 等. 胫后动脉穿支蒂岛状皮瓣修复内踝及小腿内侧创面. 中华骨科杂志, 2014, 34(8):824-830.
2.	陈居文, 李媛, 张克亮, 等. 小腿远端皮支链血管皮瓣修复足踝部缺损的疗效观察. 中国修复重建外科杂志, 2013, 27(2):253-254.
3.	唐修俊, 周信荣, 祁建平, 等. 三面会师法切取胫后动脉高位穿支蒂皮瓣修复小腿中下段骨外露. 遵义医学院学报, 2011, 34(5):512-515.
4.	沈余明, 胡骁骅, 温春泉, 等. 小腿联合肌皮瓣治疗创伤后慢性跟骨骨髓炎伴软组织缺损. 中国修复重建外科杂志, 2013, 27(9):1061-1064.
5.	付兴茂, 范韶光, 刘勇, 等. 带血管蒂腓骨头复合组织瓣修复儿童内踝缺损的初步研究. 中国修复重建外科杂志, 2013, 27(11):1305-1308.
6.	Haddock NT, Wapner K, Levin LS. Vascular bone transfer options in the foot and ankle:a retrospective review and update on strategies. Plast Reconstr Surg, 2013, 132(3):685-693.
7.	Akita S, Mitsukawa N, Rikihisa N, et al. Descending branch of the perforating branch of the peroneal artery perforator-based island flap for reconstruction of the lateral malleolus with minimal invasion. Plast Reconstr Surg, 2013, 132(2):461-469.
8.	唐修俊, 魏在荣, 王波, 等. 游离旋股外侧动脉穿支KISS皮瓣修复四肢创面的临床应用. 中华显微外科杂志, 2015, 38(1):29-32.
9.	厉孟, 蓝旭, 甄平, 等. 含斜支股前外侧游离皮瓣的设计及应用. 中国修复重建外科杂志, 2014, 28(7):865-868.
10.	申立林, 宋素萍, 蔺翠霞, 等. 吻合血管的腘动脉皮支皮瓣修复足踝部创面. 中国修复重建外科杂志, 2014, 28(1):88-91.
11.	张旭, 张大鹏, 刘志贤, 等. 胫后动脉内踝上穿支蒂皮瓣移位治疗跟踝创面. 中华显微外科杂志, 2013, 36(2):171-173.
12.	董凯旋, 徐永清, 范新宇, 等. 穿支血管蒂螺旋桨皮瓣修复足踝部软组织缺损. 中华骨科杂志, 2013, 33(10):1048-1052.
13.	魏在荣, 邵星, 帅霞, 等. 胫前动脉内踝前穿支蒂足内侧岛状皮瓣修复踝周较小创面. 中华整形外科杂志, 2010, 26(4):251-253.
14.	Tan O, Aydin OE, Demir R, et al. Neurotized sural flap:An alternative in sensory reconstruction of the foot and ankle defects. Microsurgery, 2015, 35(3):183-189.
15.	赵风林, 李宗宝, 王鑫, 等. 超薄型胫后动脉穿支皮瓣的解剖学观察与临床应用. 中华整形外科杂志, 2013, 29(4):261-264.
16.	张子阳, 张文夺, 魏在荣, 等. 数字减影血管造影在胫后动脉穿支皮瓣修复足踝部创面中的应用研究. 中国修复重建外科杂志, 2015, 29(9):1114-1117.
17.	陈斌, 郑松, 吴斌, 等. 带骨膜髂骨移植联合锁定钢板固定游离股前外皮瓣修复内踝缺损. 临床骨科杂志, 2013, 16(2):170-171.

1. 周晓, 薛明宇, 强力, 等. 胫后动脉穿支蒂岛状皮瓣修复内踝及小腿内侧创面. 中华骨科杂志, 2014, 34(8):824-830.
2. 陈居文, 李媛, 张克亮, 等. 小腿远端皮支链血管皮瓣修复足踝部缺损的疗效观察. 中国修复重建外科杂志, 2013, 27(2):253-254.
3. 唐修俊, 周信荣, 祁建平, 等. 三面会师法切取胫后动脉高位穿支蒂皮瓣修复小腿中下段骨外露. 遵义医学院学报, 2011, 34(5):512-515.
4. 沈余明, 胡骁骅, 温春泉, 等. 小腿联合肌皮瓣治疗创伤后慢性跟骨骨髓炎伴软组织缺损. 中国修复重建外科杂志, 2013, 27(9):1061-1064.
5. 付兴茂, 范韶光, 刘勇, 等. 带血管蒂腓骨头复合组织瓣修复儿童内踝缺损的初步研究. 中国修复重建外科杂志, 2013, 27(11):1305-1308.
6. Haddock NT, Wapner K, Levin LS. Vascular bone transfer options in the foot and ankle:a retrospective review and update on strategies. Plast Reconstr Surg, 2013, 132(3):685-693.
7. Akita S, Mitsukawa N, Rikihisa N, et al. Descending branch of the perforating branch of the peroneal artery perforator-based island flap for reconstruction of the lateral malleolus with minimal invasion. Plast Reconstr Surg, 2013, 132(2):461-469.
8. 唐修俊, 魏在荣, 王波, 等. 游离旋股外侧动脉穿支KISS皮瓣修复四肢创面的临床应用. 中华显微外科杂志, 2015, 38(1):29-32.
9. 厉孟, 蓝旭, 甄平, 等. 含斜支股前外侧游离皮瓣的设计及应用. 中国修复重建外科杂志, 2014, 28(7):865-868.
10. 申立林, 宋素萍, 蔺翠霞, 等. 吻合血管的腘动脉皮支皮瓣修复足踝部创面. 中国修复重建外科杂志, 2014, 28(1):88-91.
11. 张旭, 张大鹏, 刘志贤, 等. 胫后动脉内踝上穿支蒂皮瓣移位治疗跟踝创面. 中华显微外科杂志, 2013, 36(2):171-173.
12. 董凯旋, 徐永清, 范新宇, 等. 穿支血管蒂螺旋桨皮瓣修复足踝部软组织缺损. 中华骨科杂志, 2013, 33(10):1048-1052.
13. 魏在荣, 邵星, 帅霞, 等. 胫前动脉内踝前穿支蒂足内侧岛状皮瓣修复踝周较小创面. 中华整形外科杂志, 2010, 26(4):251-253.
14. Tan O, Aydin OE, Demir R, et al. Neurotized sural flap:An alternative in sensory reconstruction of the foot and ankle defects. Microsurgery, 2015, 35(3):183-189.
15. 赵风林, 李宗宝, 王鑫, 等. 超薄型胫后动脉穿支皮瓣的解剖学观察与临床应用. 中华整形外科杂志, 2013, 29(4):261-264.
16. 张子阳, 张文夺, 魏在荣, 等. 数字减影血管造影在胫后动脉穿支皮瓣修复足踝部创面中的应用研究. 中国修复重建外科杂志, 2015, 29(9):1114-1117.
17. 陈斌, 郑松, 吴斌, 等. 带骨膜髂骨移植联合锁定钢板固定游离股前外皮瓣修复内踝缺损. 临床骨科杂志, 2013, 16(2):170-171.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF V-Y ADVANCED SENSE-REMAINED POSTERIOR TIBIAL ARTERY PERFORATOR FLAP IN REPAIRING WOUND AROUND ANKLE

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