Non-microsurgical skin flaps for reconstruction of difficult wounds in distal leg and foot / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To express the versatility of a variety of non-microsurgical skin flaps used for coverage of difficult wounds in the lower third of the leg and the foot over 4 years period. Five kinds of flaps were used. Each flap was presented with detailed information regarding indication, blood supply, skin territory and technique.</p><p><b>METHODS</b>Altogether 26 patients underwent lower leg reconstruction were included in this study. The reconstructive procedures applied five flaps, respectively distally based posterior tibial artery perforator flap (n = 8), distally based peroneal artery perforator flap (n = 4), distally based sural flap (n = 6), medial planter artery flap (n = 2) and cross leg flaps (n = 6).</p><p><b>RESULTS</b>In all cases, there were no signs of osteomyelitis of underlying bones or discharge from the undersurface of the flaps. Fat necrosis occurred at the distal end of posterior tibial artery perforator flap in one female patient. The two cases of medial planter artery flap showed excellent healing with closure of donor site primarily. One cross leg flap had distal necrosis.</p><p><b>CONCLUSION</b>Would at lower third of leg can be efficiently covered by posterior tibial, peroneal artery and sural flaps. Heel can be best covered by nearby tissues such as medial planter flap. In presence of vascular compromise of the affected limb or exposure of dorsum of foot, cross leg flap can be used.</p>

Negative pressure wound therapy: An update / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To get the maximum benefit of vacuum-assisted closure (VAC) in the management of acute and chronic wounds without abuse or misuse.</p><p><b>METHODS</b>Fourty one patients were included in the study. Among them, 9 patients had chronic wounds and the rest 32 patients had acute wounds. In acute wounds, 19 patients had co-morbid conditions. Seven patients had gaped wounds, 4 patients had necrotizing fasciitis and 2 patients had enterocutaneous fistula.</p><p><b>RESULTS</b>The hospitalization period varied from 1 to 6 weeks. The follow-up period was up to 6 months. No mortality was recorded during this study. All skin grafts showed complete healing. Necrotizing fasciitis was managed with good outcome. Wounds with enterocutaneous fistula have improved. In chronic wounds, good healing and excellent outcome were obtained.</p><p><b>CONCLUSION</b>The VAC therapy is an essential element for the management of problematic acute and chronic wounds.</p>