Use of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study
Introduction: Though distally based sural artery fasciocutaneous flap is a good choice for distal leg and ankle reconstruction, shortcomings like venous congestion and flap bulkiness are matters of concern. Aim: To assess the utility of adipofascial flap for distal leg and ankle reconstruction,...
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| Autores principales: | , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/191b332762be4f6bb9f673a50907c6e6 |
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| Sumario: | Introduction: Though distally based sural artery fasciocutaneous
flap is a good choice for distal leg and ankle reconstruction,
shortcomings like venous congestion and flap bulkiness are
matters of concern.
Aim: To assess the utility of adipofascial flap for distal leg and
ankle reconstruction, complications, and long-term functional
results with range of motion at ankle joint.
Materials and Methods: A prospective cohort study (January 2018
to December 2019) was conducted at Safdarjung Hospital, New
Delhi, India on patients having distal leg defect and ankle defects
reconstructed with Distally Based Sural Artery Adipofascial Flap
(DBSAAF). Participants of any age and aetiology were included
in the study while polytrauma patients, life-threatening injuries,
mangled extremity patients were excluded. Postoperatively flap
survival, complications and functional outcome were assessed.
Results: Total 21 patients with above defects had undergone
DBSAAF reconstruction. Fifteen (71.4%) patients were males
and 6 (28.6%) were females, with mean age of 34.85 years.
Causes of defect were road traffic injury in 6 (28.6%) patients,
additional Tendoachilles tear was repaired in 5 (23.8%) patients.
Four (19%) patients had avulsion injury, 3 (14.3%) patients
had postburn unstable scar, and chronic ulcer was found in
3 (14.3%) patients. The maximum defect size was 8.5×7 cm
(mean of 5.24×4.34 cm). The width of flap pedicle was kept
at 4 cm maximum (mean=3.04 cm). All flaps were transported
to the defect site by incising the intervening bridge, tunneling
was not done. Fourteen patients did not have any co-morbidity,
whereas four patients were chronic smokers, and three were
diabetics. Flap survived completely in all patients. Three patients
had partial graft loss and one patient had chronic discharge.
Follow-up for maximum of six months (mean=4.04 months)
were done.
Conclusion: DBSAAF is a reliable flap for defects of distal leg
and ankle region. Advantages are aesthetically better donor
area, normal contour, and minimal scarring. It does not require
a secondary debulking making it a one stage procedure and
allowing patients to use their normal footwear. |
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