RESUMO
Objective:To investigate clinical effect of free perforator flap pedicled on medial sural artery in reconstruction of defect in left foot of squamous cell carcinoma surgery.Methods:From June 2017 to December 2019, 7 patients with chronic wounds in feet were diagnosed with highly differentiated squamous cell carcinoma of foot. The patients were treated at the Department of Microsurgical Wound Repair Surgery of Hand and Foot, Traditional Chinese Medicine Hospital of Panyu District in Guangzhou. Surgery were performed to remove the cancer and the defects in the feet caused by surgery were reconstructed with transfers of ipsilateral free perforator flaps pedicled on medial sural artery. The patients were 4 males and 3 females, aged 24-68 years old, with an average of 37 years old. Sizes of wound after resection of cancer was 2.5 cm×5.5 cm to 4.0 cm×8.0 cm. The flaps sized 3.0 cm×6.0 cm to 4.5 cm×10.0 cm. All the donor sites were directly sutured. Scheduled postoperative follow-ups were conducted. Investigation items included colour and texture of flap, flap sensation, walking condition and donor site healing.Results:All 7 flaps survived after surgery. One patient had a marginal necrosis on flap after surgery, and the wound was healed after active dressing change. All patients had completed a 12-18 months follow-up, with 15.1 months in average. One patient had a marginal necrsis on flap after surgery, and the wound was healed after active dressing change. All flaps were soft in texture, in elastic and without bulky. All the feet had good load-bearing function. There were only linear scars in the donor sites without obvious dysfunction. All patients had normal gait. No infiltration, sinus or chronic ulcer was found in recipient sites, and there was no recurrence of cancer or lymph node metastasis. Three flaps with sutured cutaneous nerves showed protective senation.Conclusion:The use of a free perforator flap pedicled on medial sural artery to reconstruct the soft tissue defect wound after tumer resection of squamous cell carcinoma in foot can be performed in same surgical field. Anatomical location of the perforator vessels is relatively constant and the flap is relatively easy to take. Damage to the donor site is minimum. It is one of the effective methods for wound repair.