RESUMEN
PURPOSE: The sural flap has often been used to cover the weight-bearing and non-weight-bearing areas of the foot and ankle. This study reports our experience in the coverage of these defects in the foot in weight-bearing areas. PATIENTS AND METHOD: This is a retrospective and descriptive study of 70 months. This study includes 16 patients presenting a loss of plantar substance and/or heel of the foot covered by a sural flap with a distal pedicle. The sampling technique described by Masquelet served as our reference. An increase in the length of the pedicle of at least two centimeters during the dissection made it possible to avoid any stretching or compression for the most distal lesions. RESULTS: The average age was 35 years with a sex ratio of three in favor of men. Traumatic lesions predominated (n=10) with an average area of lesions of 68.8cm2. The average partial and total support times were 1.8 and 3.6 months respectively. We noted one case of flap necrosis. The natural evolution of the flap took place in three progressive stages: regeneration, keratinization and squamous metaplasia. Normal bipodal support and stable gait without footwear anomaly were noted in 15 cases. CONCLUSION: The distal pedicle sural flap technique is accessible. Its reliability makes it an ideal choice for distal loss of substance to the leg and foot.
Asunto(s)
Talón , Colgajos Quirúrgicos , Masculino , Humanos , Adulto , Talón/cirugía , Estudios Retrospectivos , Reproducibilidad de los Resultados , Complicaciones PosoperatoriasRESUMEN
Burns are frequent lesions, often leading to serious functional or even life-threatening sequelae. Their care poses a problem in the countries of the South due to the lack of specialized centres. Through this study, we would like to share our experience. This was a descriptive retrospective study carried out over 36 months on 24 patients treated and followed up in the department for burn sequelae involving a limb. Functional results were classified as excellent, good, fairly good, fair and poor. Aesthetically, they have been categorized into satisfactory, unsatisfactory and poor. We recorded 1480 patients who underwent surgery, 24 of whom were operated on after burns. We noted a female predominance (sex ratio of 1.6) with an average age of 24.2 years (range 16-40). Domestic accidents (n=19) were the main circumstance of occurrence and there was a preponderance of thermal burns by flame (n=21). Twenty people were treated in the first year after burn with excellent, good and fair results in 10, 9 and 4 cases respectively. Burns can cause significant functional sequelae, the management of which requires specialized nursing staff. Training of caregivers oriented towards burn care without forgetting the related means remains a key element to minimizing the occurrence of these sequelae.