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Volume 39 Issue 10
Oct.  2023
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(10): 926-932
Ji P,Cao T,Zhang Z,et al.Effects of the anterolateral thigh chimeric perforator flaps in repairing complex wounds of foot and ankle[J].Chin J Burns Wounds,2023,39(10):926-932.DOI: 10.3760/cma.j.cn501225-20230627-00232.
Citation: Ji P,Cao T,Zhang Z,et al.Effects of the anterolateral thigh chimeric perforator flaps in repairing complex wounds of foot and ankle[J].Chin J Burns Wounds,2023,39(10):926-932.DOI: 10.3760/cma.j.cn501225-20230627-00232.
shu

Effects of the anterolateral thigh chimeric perforator flaps in repairing complex wounds of foot and ankle

doi: 10.3760/cma.j.cn501225-20230627-00232
  • 1.

    Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China

  • 2.

    Department of Orthopedics, Xingping People's Hospital, Xingping 713100, China

  • 3.

    Department of Wound Repair, Center for Wound Repair and Regenerative Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China

Funds:

General Program of National Natural Science Foundation of China 82272269

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    Abstract
  •   Objective   To investigate the effects of anterolateral thigh chimeric perforator flap in repairing complex wounds of foot and ankle.   Methods   A retrospective observational study was conducted. From May 2018 to June 2022, 23 patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University to repair complex wounds of foot and ankle with anterolateral thigh chimeric perforator flaps, including 15 males and 8 females, aged from 20 to 66 years. The wounds were all accompanied by bone exposure and defects, and were complicated with varying degrees of infection. All patients underwent debridement and continuous vacuum sealing drainage treatment for 1 week in stage Ⅰ, with the skin and soft tissue defect area after debridement being 10 cm×5 cm to 22 cm×7 cm. In stage Ⅱ, the anterolateral thigh chimeric perforator flap was used to cover the defective wound, of which the muscle flap was used to fill the deep invalid cavity of the ankle joint or cover bone and internal fixation exposures, and the skin flap was used to cover the superficial wound, with the area of the skin flap ranging from 11 cm×6 cm to 23 cm×8 cm, and the area of the muscle flap ranging from 4.0 cm×2.5 cm to 8.0 cm×5.0 cm. The survival of the flap was observed after operation. During follow-up, the color, texture, appearance, and complications of the flap were observed, the function of ankle joint and its range of dorsiflexion motion and plantar flexion motion were measured, and the scar hyperplasia and muscular hernia in donor area were observed.   Results   Ecchymosis and epidermal necrosis occurred at the tip of the flap in 1 patient on 5 days after operation and healed after dressing change for 1 week; the other flaps of patients survived successfully. After 6 to 40 months of follow-up, the color, texture, and shape of flaps were good, but 1 patient was not satisfied with the shape of the flap because of flap swelling; the ankle joint movement was basically normal, the dorsiflexion motion was 15-30°, and the plantar flexion motion was 20-45°; the scar hyperplasia in the donor area of the flap was not obvious, and no muscular hernia occurred.   Conclusions   The anterolateral thigh chimeric perforator flap can effectively fill the deep invalid cavity of ankle joint and cover the superficial wound at the same time, with minimal damage to the donor site. So it is an ideal flap for repairing the complex wounds of foot and ankle.

     

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    • References(26)
  • [1]
    TummalaSV, MorikawaL, BrinkmanJC, et al. Characterization of ankle injuries and associated risk factors in the National Basketball Association: minutes per game and usage rate associated with time loss[J]. Orthop J Sports Med, 2023,11(7):23259671231184459. DOI: 10.1177/23259671231184459.
    [2]
    DhodapkarMM, HalperinSJ, GardnerEC, et al. Orthopaedic injury patterns related to ice skating, inline skating, and roller skating: a 20-year epidemiologic analysis[J]. Orthop J Sports Med, 2023,11(9):23259671231198208. DOI: 10.1177/23259671231198208.
    [3]
    DuS, WeiS, ZhangH, et al. Comparison of "complications" and functional outcome of anterolateral thigh flap and sural neurofasciocutaneus flap for foot and ankle reconstruction: a single center cohort study[J]. Injury, 2022,53(11):3843-3848. DOI: 10.1016/j.injury.2022.08.068.
    [4]
    吴文溢, 余少校, 周望高, 等. 以旋股外侧动脉降支为蒂的分叶-嵌合穿支皮瓣修复足踝多部位缺损伤六例[J].中华显微外科杂志,2022,45(4):400-405. DOI: 10.3760/cma.j.cn441206-20220214-00032.
    [5]
    王嘉正, 施忠民. 足踝外科领域患者报告结局的研究进展[J].中华骨科杂志,2023,43(2):143-148. DOI: 10.3760/cma.j.cn121113-20220809-00433.
    [6]
    胡智玉, 宋力, 周明武, 等. 串联组合式穿支嵌合组织瓣修复重建足踝部复合组织缺损六例[J].中华显微外科杂志,2021,44(1):68-71. DOI: 10.3760/cma.j.cn441206-20191219-00393.
    [7]
    DhodapkarMM, HalperinSJ, GardnerEC, et al. Orthopaedic injury patterns related to ice skating, inline skating, and roller skating: a 20-year epidemiologic analysis[J]. Orthop J Sports Med, 2023,11(9):23259671231198208. DOI: 10.1177/23259671231198208.
    [8]
    唐举玉, 贺继强, 吴攀峰, 等. 旋股外侧动脉降支嵌合穿支皮瓣立体修复合并深部死腔的下肢软组织缺损[J].中华显微外科杂志,2018,41(5):424-427. DOI: 10.3760/cma.j.issn.1001-2036.2018.05.003.
    [9]
    HuangQ, WangQ, XuY, et al. Dual-perforator flap with wide pedicle versus sural neurocutaneous flap with peroneal artery perforator in the treatment of soft tissue defects of foot and ankle [J]. J Foot Ankle Surg, 2023,62(1):150-155. DOI: 10.1053/j.jfas.2022.06.003.
    [10]
    陈黎明, 王刚, 刘毅. 低位旋转点的外踝上穿支岛状皮瓣修复足部皮肤软组织缺损创面的临床效果[J].中华烧伤与创面修复杂志,2022,38(10):932-936. DOI: 10.3760/cma.j.cn501120-20210630-00231.
    [11]
    TanJ, ChenJ, ZhouJ, et al. Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis[J/OL]. Burns Trauma, 2019, 7:17[2023-06-27].https://pubmed.ncbi.nlm.nih.gov/31139664/. DOI: 10.1186/s41038-019-0151-6.
    [12]
    WangY, LiuJ, XieJ, et al. The effects of platelet-rich plasma combined with a skin flap transplant on open foot fractures with soft tissue defects[J]. Am J Transl Res, 2021,13(6):6662-6669.
    [13]
    ZhengX, ZhengC, WangB, et al. Reconstruction of complex soft-tissue defects in the extremities with chimeric anterolateral thigh perforator flap[J]. Int J Surg, 2016, 26:25-31. DOI: 10.1016/j.ijsu.2015.12.035.
    [14]
    OuQ, WuP, PanD, et al. Combined transfer by several perforator skin flaps to cover an extensive and multiplanar wound on the foot and ankle[J]. J Plast Reconstr Aesthet Surg, 2022,75(10):3751-3760. DOI: 10.1016/j.bjps.2022.06.081.
    [15]
    NoamanHH, MohamedMA, FaisalA, et al. Different surgical procedures for reconstruction of soft-tissue defects around the ankle[J]. Injury, 2022,53(7):2657-2665. DOI: 10.1016/j.injury.2022.03.066.
    [16]
    LvZ, WangQ, JiaR, et al. Pelnac® artificial dermis assisted by VSD for treatment of complex wound with bone/tendon exposed at the foot and ankle, a prospective study [J]. J Invest Surg, 2020,33(7):636-641. DOI: 10.1080/08941939.2018.1536177.
    [17]
    罗高杰, 唐举玉, 卿黎明. 分叶穿支皮瓣的临床应用进展[J].中华显微外科杂志,2022,45(3):346-351. DOI: 10.3760/cma.j.cn441206-20220302-00043.
    [18]
    QingL, WuP, YuF, et al. Use of dual-skin paddle anterolateral thigh perforator flaps in the reconstruction of complex defect of the foot and ankle[J]. J Plast Reconstr Aesthet Surg, 2018,71(9):1231-1238. DOI: 10.1016/j.bjps.2018.05.029.
    [19]
    HallockGG. Simultaneous transposition of anterior thigh muscle and fascia flaps: an introduction to the chimera flap principle[J]. Ann Plast Surg, 1991, 27(2):126-131. DOI: 10.1097/00000637-199108000-00006.
    [20]
    吴泽东, 郑和平. 嵌合穿支皮瓣的发展与现状[J].临床外科杂志,2015(5):330-333. DOI: 10.3969/j.issn.1005-6483.2015.05.003.
    [21]
    ZhengHP, ZhuangYH, ZhangZM, et al. Modified deep iliac circumflex osteocutaneous flap for extremity reconstruction: anatomical study and clinical application[J]. J Plast Reconstr Aesthet Surg, 2013,66(9):1256-1262. DOI: 10.1016/j.bjps.2013.04.057.
    [22]
    唐举玉. 特殊形式穿支皮瓣及其衍生术式的分型与命名[J].中华显微外科杂志,2021,44(3):245-254. DOI: 10.3760/cma.j.cn441206-20210530-00193.
    [23]
    唐举玉, 卿黎明, 吴攀峰, 等. 游离腹壁下动脉嵌合穿支皮瓣修复合并深部死腔的下肢皮肤软组织缺损[J].中华整形外科杂志, 2015, 31(6):4.DOI: 10.3760/cma.j.issn.1009-4598.2015.06.007.
    [24]
    LiH, WangZ, GuB, et al. Postburn neck reconstruction with preexpanded upper back perforator flaps: free-style design and an update of treatment strategies[J]. Ann Plast Surg, 2018,81(1):45-49. DOI: 10.1097/SAP.0000000000001491.
    [25]
    刘毅. 重视供区的美容修复[J].中华烧伤杂志,2020,36(2):81-84. DOI: 10.3760/cma.j.issn.1009-2587.2020.02.001.
    [26]
    杜伟力, 沈余明, 胡骁骅, 等. 供瓣区美学修复方法的探讨[J].中华烧伤杂志,2020,36(2):97-105. DOI: 10.3760/cma.j.issn.1009-2587.2020.02.004.
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