Objective To investigate clinical application of the free peroneal artery perforator flap in soft tissue defect of foot and ankle.Methods The clinical data of 18 patients with soft tissue defects of foot and ankle who were repaired with free peroneal artery perforator flaps between March 2019 and March 2020 were retrospectively analyzed. Among them, there were 11 males and 7 females; the age ranged from 21 to 58 years, with an average age of 45 years. The defect was located in the ankle in 2 cases, in the hindfoot in 4 cases, in the midfoot in 5 cases, and in the forefoot in 7 cases. The causes of injury included 11 cases of traffic accident, 4 cases of machine injuries, 3 cases of infection and necrosis after internal fixation. The time from injury to flap repair was 12-48 days, with an average of 24 days. The range of wound was 3 cm×3 cm to 15 cm×8 cm, and the range of skin flap was 4 cm×3 cm to 16 cm×9 cm. The flap harvesting time, operation time, intraoperative blood loss, and complications were recorded; the flap survival and patient satisfaction were observed during follow-up; and the American Orthopaedic Foot and Ankle Society (AOFAS) foot function score was used to evaluate the foot function.Results The flap harvesting time was 15-33 minutes (mean, 22 minutes); the operation time was 120-160 minutes (mean, 150 minutes); the intraoperative blood loss was 90-180 mL (mean, 120 mL). There were 3 cases of vascular crisis after operation, including 2 cases of arterial crisis, which survived after vascular exploration and vein graft repair; 1 case of venous crisis, partial necrosis of the skin flap, and skin grafting to cover the wound after repeated debridement. The remaining 15 skin flaps survived completely. All patients were followed up 6 months. The skin flaps were in good shape without obvious bloat. According to the AOFAS foot function score, 5 cases were excellent, 10 cases were good, and 3 cases were fair. The excellent and good rate was 83.3%.Conclusion The free peroneal artery perforator flap is easy to harvest, the shape and size of the flap are easy to design, and it does not damage the main blood vessels of the limb. The appearance and function of the limbs are satisfactory after operation. It can be widely used in the repair of soft tissue defects of the foot and ankle.
Citation：
SONG Jialin, HUANG Tengli, GAO Tao, BAO Bingbo, LIN Junqing, ZHONG Wanrun, ZHENG Xianyou. Clinical application of free peroneal artery perforator flap in soft tissue defect of foot and ankle. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(6): 756-760. doi: 10.7507/1002-1892.202101069
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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陈占斌, 朱爱祥, 曹广超, 等. 游离股前外侧皮瓣坏死的危险因素探讨. 创伤外科杂志, 2020, 22(11): 856-859.
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Scaglioni MF, Kuo YR, Chen YC. Reconstruction of distal hand and foot defects with the free proximal peroneal artery perforator flap. Microsurgery, 2016, 36(3): 183-190.
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Bekara F, Herlin C, Somda S, et al. Free versus perforator pedicled propeller flaps in lower extremity reconstruction: what is the safest coverage? A meta-analysis. Microsurgery, 2018, 38(1): 109-119.
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Yasir M, Wani AH, Zargar HR. Perforator flaps for reconstruction of lower limb defects. World J Plast Surg, 2017, 6(1): 74-81.
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王剑利, 赵刚, 王五洲, 等. 游离皮瓣移植 1270 例回顾性研究. 中华显微外科杂志, 2012, 35(3): 189-193.
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Kawamura K, Yajima H, Kobata Y, et al. Clinical applications of free soleus and peroneal perforator flaps. Plast Reconstr Surg, 2005, 115(1): 114-119.
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李匡文, 唐举玉, 刘昌雄, 等. 游离腓动脉穿支皮瓣的临床研究. 中华显微外科杂志, 2011, 34(5): 403-405.
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吴伟炽, 黄东, 祝李霖, 等. 腓动脉穿支皮瓣的解剖学研究. 实用手外科杂志, 2016, 30(2): 149-151.
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- 1. 侯春林, 顾玉东. 皮瓣外科学. 3 版. 上海: 上海科学技术出版社, 2013: 186-272.
- 2. 徐永清, 范新宇. 穿支皮瓣临床应用的若干问题探讨. 中华创伤杂志, 2014, 11(82): 1082-1084.
- 3. 姚刚, 周芳, Peter C Neligan, 等. 穿支皮瓣在组织器官缺损修复和再造中的应用. 中国修复重建外科杂志, 2007, 21(6): 621-624.
- 4. 智丰, 王龙虎, 梁高峰, 等. 应用游离腓动脉穿支皮瓣修复手足软组织缺损 16 例. 中华显微外科杂志, 2012, 35(5): 411-413.
- 5. 陈占斌, 朱爱祥, 曹广超, 等. 游离股前外侧皮瓣坏死的危险因素探讨. 创伤外科杂志, 2020, 22(11): 856-859.
- 6. Scaglioni MF, Kuo YR, Chen YC. Reconstruction of distal hand and foot defects with the free proximal peroneal artery perforator flap. Microsurgery, 2016, 36(3): 183-190.
- 7. Bekara F, Herlin C, Somda S, et al. Free versus perforator pedicled propeller flaps in lower extremity reconstruction: what is the safest coverage? A meta-analysis. Microsurgery, 2018, 38(1): 109-119.
- 8. 严广斌. AOFAS 踝-后足评分系统. 中华关节外科杂志 (电子版), 2014, 8(4): 151.
- 9. Yasir M, Wani AH, Zargar HR. Perforator flaps for reconstruction of lower limb defects. World J Plast Surg, 2017, 6(1): 74-81.
- 10. 孙军, 颜屈伦, 池雷霆. 足踝部软组织缺损的显微外科修复. 实用手外科杂志, 2009, 23(1): 19-21.
- 11. 王剑利, 赵刚, 王五洲, 等. 游离皮瓣移植 1270 例回顾性研究. 中华显微外科杂志, 2012, 35(3): 189-193.
- 12. Kawamura K, Yajima H, Kobata Y, et al. Clinical applications of free soleus and peroneal perforator flaps. Plast Reconstr Surg, 2005, 115(1): 114-119.
- 13. 李匡文, 唐举玉, 刘昌雄, 等. 游离腓动脉穿支皮瓣的临床研究. 中华显微外科杂志, 2011, 34(5): 403-405.
- 14. 吴伟炽, 黄东, 祝李霖, 等. 腓动脉穿支皮瓣的解剖学研究. 实用手外科杂志, 2016, 30(2): 149-151.
