RECONSTRUCTION OF POSTBURN POPLITEAL FOSSA CONTRACTURES USING POPLITEAL FOSSA MIDDLE ARTERY PEDICLED FLAPS IN CHILDREN_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WEI Zairong , SUN Guangfeng , TANG Xiujun , DENG Chengliang , JIN Wenhu , WANG Dali , WANG Bo.

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003, P.R.China. Corresponding author: WEI Zairong, E-mail: zairongwei@sina.com;

Corresponding author：

Keywords：

Popliteal fossa middle artery pedicled flap; Popliteal fossa contracture; Wound repair; Children

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Objective To investigate the characteristics of blood supply of popliteal fossa middle artery pedicled flaps and the feasibility of reconstruction of postburn popliteal fossa contractures using the flaps in children. Methods Between January 2008 and October 2010, 6 cases of postburn popliteal fossa contractures were recontructed using popliteal fossa middle artery pedicled flaps. Of them, 2 were boys and 4 were girls, aged from 2 years and 2 months to10 years. All burns were caused by hot water. The wound ranged from 5 cm × 4 cm to 10 cm × 8 cm after scar relaxation. The size of the flap ranged from 6 cm × 4 cm to 11 cm × 9 cm. Donor sites were covered with split-thickness skin graft in 5 cases, and sutured directly in 1 case. Results All the flaps and the skingraft survived; no vascular crisis or flap necrosis occurred. All incisions at donors and wounds healed by first intention. All patients were followed up 12-24 months. The color, texture, and appearance of the flaps were good. Hyperplastic scar was found at incision of popliteal fossa in 1 case at 6 months after operation; the range of motion (ROM) of the knee joint was 0-175°, and no obvious change was observed at 15 months after operation. The others had no functional disturbance of the knee joints or claudication; the ROM of the knee joint was 0-180°. Conclusion The popliteal fossa middle artery pedicled flap has reliable blood supply, simple operative procedure, and good results in reconstruction of popliteal fossa contracture.

Citation： WEI Zairong,SUN Guangfeng,TANG Xiujun,DENG Chengliang,JIN Wenhu,WANG Dali,WANG Bo.. RECONSTRUCTION OF POSTBURN POPLITEAL FOSSA CONTRACTURES USING POPLITEAL FOSSA MIDDLE ARTERY PEDICLED FLAPS IN CHILDREN. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(8): 946-949. doi: Copy

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2.	Motamed S, Hasanpoor SE, Moosavizadeh SM, et al. Treatment of flexion contractures following burns in extremities. Burns, 2006, 32(8): 1017-1021.
3.	魏在荣, 邵星, 谢月, 等. 腓肠肌内侧头穿支皮瓣对腘窝瘢痕创面的修复. 中华烧伤杂志, 2010, 26(4): 260-262.
4.	鲁开化, 郭树忠, 艾玉峰, 等. 烧伤后下肢严重瘢痕挛缩的治疗. 中华烧伤杂志, 2004, 20(2): 69-71.
5.	Goldberg DP, Kucan JO, Bash D. Reconstruction of the burned foot. Clin Plast Surg, 2000, 27(1): 145-161.
6.	王会军, 张捷, 蒋永能, 等. 小腿后侧皮瓣修复膝关节深度烫伤八例. 中华烧伤杂志, 2008, 24(1): 60.
7.	简玉洛, 王晓, 张自清. 小腿后侧筋膜皮瓣的临床应用. 中华显微外科杂志, 2004, 27(1): 56-57.
8.	Del Piñal F, García-Bernal FJ, Delgado J. Is posttraumatic first web contracture avoidable? Prophylactic guidelines and treatment-oriented classication. Plast Reconstr Surg, 2004, 113(6): 1833-1860.
9.	Grishkevich VM. The post-burn elbow medial exion scar contracture treatment with trapeze-ap plasty. Burns, 2009, 35(2): 280-287.
10.	Eom JS, Sun SH, Hong JP. Use of the upper medial thigh perforator flap (gracilis perforator flap) for lower extremity reconstruction. Plast Reconstr Surg, 2011, 127(2): 731-737.
11.	Stillaert FB, Casaer B, Roche N, et al. The inframammary extending lateral intercostal artery perforator flap for reconstruction of axillary contractures: a case report. J Plast Reconstr Aesthet Surg, 2008, 61(12): e7-11.
12.	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.
13.	McGregor IA, Morgan G. Axial and random pattern flaps. Br J Plast Surg, 1973, 26(3): 202-213.
14.	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.
15.	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): 9-11.
16.	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.
17.	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.
18.	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.
19.	陈世新, 吴东方, 丁茂超, 等. 穿支体区血管及其相互间吻合的3D可视化研究. 中国临床解剖学杂志, 2011, 29(3): 237-242.
20.	魏在荣, 肖尔禅, 谭静, 等. 胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损. 中国修复重建外科杂志, 2010, 24(5): 635-636.
21.	魏在荣, 王甜甜, 税兰, 等. 第一掌背动脉蒂网状供血分叶皮瓣修复拇示指不规则创面. 中国修复重建外科杂志, 2010, 24(1): 46-49.
22.	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. Uygur F, Duman H, Ulkür E, et al. Are reverse flow fasciocutaneous flaps an appropriate option for the reconstruction of severe postburn lower extremity contractures? Ann Plast Surg, 2008, 61(3): 319-324.
2. Motamed S, Hasanpoor SE, Moosavizadeh SM, et al. Treatment of flexion contractures following burns in extremities. Burns, 2006, 32(8): 1017-1021.
3. 魏在荣, 邵星, 谢月, 等. 腓肠肌内侧头穿支皮瓣对腘窝瘢痕创面的修复. 中华烧伤杂志, 2010, 26(4): 260-262.
4. 鲁开化, 郭树忠, 艾玉峰, 等. 烧伤后下肢严重瘢痕挛缩的治疗. 中华烧伤杂志, 2004, 20(2): 69-71.
5. Goldberg DP, Kucan JO, Bash D. Reconstruction of the burned foot. Clin Plast Surg, 2000, 27(1): 145-161.
6. 王会军, 张捷, 蒋永能, 等. 小腿后侧皮瓣修复膝关节深度烫伤八例. 中华烧伤杂志, 2008, 24(1): 60.
7. 简玉洛, 王晓, 张自清. 小腿后侧筋膜皮瓣的临床应用. 中华显微外科杂志, 2004, 27(1): 56-57.
8. Del Piñal F, García-Bernal FJ, Delgado J. Is posttraumatic first web contracture avoidable? Prophylactic guidelines and treatment-oriented classication. Plast Reconstr Surg, 2004, 113(6): 1833-1860.
9. Grishkevich VM. The post-burn elbow medial exion scar contracture treatment with trapeze-ap plasty. Burns, 2009, 35(2): 280-287.
10. Eom JS, Sun SH, Hong JP. Use of the upper medial thigh perforator flap (gracilis perforator flap) for lower extremity reconstruction. Plast Reconstr Surg, 2011, 127(2): 731-737.
11. Stillaert FB, Casaer B, Roche N, et al. The inframammary extending lateral intercostal artery perforator flap for reconstruction of axillary contractures: a case report. J Plast Reconstr Aesthet Surg, 2008, 61(12): e7-11.
12. 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.
13. McGregor IA, Morgan G. Axial and random pattern flaps. Br J Plast Surg, 1973, 26(3): 202-213.
14. 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.
15. 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): 9-11.
16. 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.
17. 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.
18. 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.
19. 陈世新, 吴东方, 丁茂超, 等. 穿支体区血管及其相互间吻合的3D可视化研究. 中国临床解剖学杂志, 2011, 29(3): 237-242.
20. 魏在荣, 肖尔禅, 谭静, 等. 胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损. 中国修复重建外科杂志, 2010, 24(5): 635-636.
21. 魏在荣, 王甜甜, 税兰, 等. 第一掌背动脉蒂网状供血分叶皮瓣修复拇示指不规则创面. 中国修复重建外科杂志, 2010, 24(1): 46-49.
22. 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

RECONSTRUCTION OF POSTBURN POPLITEAL FOSSA CONTRACTURES USING POPLITEAL FOSSA MIDDLE ARTERY PEDICLED FLAPS IN CHILDREN

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