Fasciocutaneous flap pedicle with the perforating branches of posterior tibial artery in repairing leg soft tissue defect / 中国组织工程研究

ABSTRACT

Sixteen patients underwent fasciocutaneous flap pedicle with the perforating branches of posterior tibial artery to repair the skin defects of the middle and lower leg in Department of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from February 2003 to February 2007.Based on anatomy,the flap axis ray was designed as the connection of internal condyle of tibia and the middle point between inner malleolus and achilles tendon,rotating along the axis ray adjacent to wound with pedicle having perforating branches of posterior tibial artery.Under guidance of Doppler flowmeter,all skin including flap,pedicle,and surface of perforating branches must be fine.The upper leg skin defect was repaired using anterograde flap,and the middle-lower leg skin defect was repaired using retrograde flap,including lower leg defect in 9 cases,middle leg defect in 3 cases and upper leg defect in 4 cases.The skin defects ranged from 2.0 cm?1.5 cm to 12.5 cm?7.5 cm,and the largest size of flap was about 15.0 cm?10 cm,and the smallest size of flap was about 4.0 cm?2.5 cm.The repairing effect was observed.All flaps survived.Two cases developed distal necrosis of skin,but granulation was found in subcutaneous tissue,of which 1 case healed after changing dressings,and the other recovered after skin grating.All subjects were followed up for over 6 months.All cases could walk naturally but felt pain.Fasciocutaneous flap pedicle with the perforating branches of posterior tibial artery can repair the skin defects of leg soft tissue.The donor site is posterior leg.The pedicel is kept well after injury,and the flap is easy to design.In addition,the blood supply is reliable,and survival rate is high.It is a good surgery to repair leg soft tissue defect.