Volume 39 Issue 4
Apr.  2023
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Guo XF,Deng XX,Huang ZH,et al.Effects of pedicled flap combined with membrane induction technique in repairing foot and ankle wounds in diabetic patients[J].Chin J Burns Wounds,2023,39(4):325-329.DOI: 10.3760/cma.j.cn501225-20221212-00534.
Citation: Guo XF,Deng XX,Huang ZH,et al.Effects of pedicled flap combined with membrane induction technique in repairing foot and ankle wounds in diabetic patients[J].Chin J Burns Wounds,2023,39(4):325-329.DOI: 10.3760/cma.j.cn501225-20221212-00534.

Effects of pedicled flap combined with membrane induction technique in repairing foot and ankle wounds in diabetic patients

doi: 10.3760/cma.j.cn501225-20221212-00534
Funds:

Scientific and Technological Achievements and Suitable Technology Promotion Project of Wuxi Municipal Health Commission T2020122

Taihu Lake Talent Plan Project of Wuxi Municipal Government 2020WXTH-14

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  •   Objective   To explore the effects of pedicled flap combined with membrane induction technique in repairing foot and ankle wounds in diabetic patients.   Methods   A retrospective observational study was conducted. From March 2019 to July 2021, 12 patients with diabetic foot and ankle wounds who met the inclusion criteria were admitted to Wuxi Ninth People's Hospital, including 7 males and 5 females, aged 20 to 92 years. The wound area before debridement was 4.0 cm×2.5 cm to 16.0 cm×12.5 cm. The patients underwent debridement+antibiotic cement tamponade in stage Ⅰ; according to the wound site, peroneal artery perforator flap or posterior tibial artery perforator flap was chosen to repair the wound in stage Ⅱ, with the area of the resected flap ranging from 4.5 cm×3.0 cm to 18.5 cm×14.0 cm. The donor site was directly closed in 4 patients or covered by full-thickness inguinal skin graft in 8 patients. After the operation of stage Ⅱ, the survival of flap and skin graft, the scar in donor and recipient sites of flap, the appearance of flap, and the function of ankle joint of affected extremity were followed up. The recovery of foot and ankle function was evaluated and rated by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scoring System at the last follow-up.   Results   During the follow-up of 4 to 15 months after the operation of stage Ⅱ, both the flap and skin graft survived, without obvious infection recurrence. Linear scars were left in donor and recipient sites of flap, with good appearance in flap. The function of ankle joint in the affected extremity was nearly normal. At the last follow-up, the AOFAS scores of patients were 79 to 93, with excellent in 8 cases and good in 4 cases.   Conclusions   The pedicled flap combined with membrane induction technique for repairing foot and ankle wounds in diabetic patients has the advantage of simple operation, preserved ankle joint function, and less postoperative infection recurrence, which is worth popularizing in clinical practice.

     

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