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: ARCHANA SINHA, SUVASHIS DASH, SNEHA SHARMA, SUNIL SHARMA
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Lenguaje:EN
Publicado: JCDR Research and Publications Private Limited 2021
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spelling oai:doaj.org-article:191b332762be4f6bb9f673a50907c6e62021-11-12T11:54:30ZUse of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study10.7860/JCDR/2021/49447.154322249-782X0973-709Xhttps://doaj.org/article/191b332762be4f6bb9f673a50907c6e62021-09-01T00:00:00Zhttps://www.jcdr.net/articles/PDF/15432/49447_CE[Ra1]_F[SH]_PF1(AG_SHU)_PFA(AG_KM)_PN(KM).pdfhttps://doaj.org/toc/2249-782Xhttps://doaj.org/toc/0973-709XIntroduction: 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.ARCHANA SINHASUVASHIS DASHSNEHA SHARMASUNIL SHARMAJCDR Research and Publications Private Limitedarticleadipofascial flapdistally based flapleg reconstructionsoft tissue reconstructiontrauma reconstructionturnover flapMedicineRENJournal of Clinical and Diagnostic Research, Vol 15, Iss 9, Pp PC18-PC22 (2021)
institution DOAJ
collection DOAJ
language EN
topic adipofascial flap
distally based flap
leg reconstruction
soft tissue reconstruction
trauma reconstruction
turnover flap
Medicine
R
spellingShingle adipofascial flap
distally based flap
leg reconstruction
soft tissue reconstruction
trauma reconstruction
turnover flap
Medicine
R
ARCHANA SINHA
SUVASHIS DASH
SNEHA SHARMA
SUNIL SHARMA
Use of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study
description 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.
format article
author ARCHANA SINHA
SUVASHIS DASH
SNEHA SHARMA
SUNIL SHARMA
author_facet ARCHANA SINHA
SUVASHIS DASH
SNEHA SHARMA
SUNIL SHARMA
author_sort ARCHANA SINHA
title Use of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study
title_short Use of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study
title_full Use of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study
title_fullStr Use of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study
title_full_unstemmed Use of Adipofascial Reverse Sural Artery Flap for Distal Leg and Ankle Region ReconstructionA Prospective Cohort Study
title_sort use of adipofascial reverse sural artery flap for distal leg and ankle region reconstructiona prospective cohort study
publisher JCDR Research and Publications Private Limited
publishDate 2021
url https://doaj.org/article/191b332762be4f6bb9f673a50907c6e6
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