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A modified perforator-based stepladder V-Y advancement flap in the Achilles tendon area for coverage of larger posterior heel defects.
Huang, Hai-Hua; Wu, Ze-Yong; Chen, Xiu-Feng; Shi, Yu-Cang; Xu, Shu-Hao; Wang, Sui-Jiang; Huang, Yue-Sheng.
Afiliación
  • Huang HH; Department of Wound Repair, Institute of Wound Repair and Regeneration Medicine, Southern University of Science and Technology Hospital, Southern University of Science and Technology School of Medicine, Shenzhen, Guangdong, 518055, China.
  • Wu ZY; Department of Plastic Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China.
  • Chen XF; Department of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China.
  • Shi YC; Department of Plastic Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China.
  • Xu SH; Department of Plastic Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China.
  • Wang SJ; Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, 510317, China. Electronic address: 2008wsj.zj@163.com.
  • Huang YS; Department of Wound Repair, Institute of Wound Repair and Regeneration Medicine, Southern University of Science and Technology Hospital, Southern University of Science and Technology School of Medicine, Shenzhen, Guangdong, 518055, China. Electronic address: yshuang1958@163.com.
J Plast Reconstr Aesthet Surg ; 77: 31-38, 2023 02.
Article en En | MEDLINE | ID: mdl-36549121
BACKGROUND: Posterior heel defect coverage is challenging because of the paucity of suitable flaps. The traditional local stepladder V-Y advancement flap is recommended only for small defects because of the lack of an axial pedicle. This study reports our experience of using the perforator-based stepladder V-Y advancement flaps in a larger posterior heel defect repair. METHODS: Twenty-two patients with posterior heel defects were treated with modified perforator-based stepladder V-Y advancement flaps in the Achilles tendon area for 11 years. Sixteen males and six females aged 3-74 years underwent surgery. The defect size, perforator characteristics, flap size, flap movement, sural nerve, lesser saphenous vein, deep fascia, flap survival, and outcome quality were analyzed. RESULTS: The perforators were found to predominate within two 2-cm intervals: 0-2 cm and 4-6 cm proximal to the tip of the lateral malleolus. Twenty-one perforator-based flaps healed uneventfully, and only one developed tip necrosis on the lower edge, which healed by secondary intention. The maximum distance of distal movement was 5.0 cm for the modified flap in contrast to 2.5 cm for the traditional flap. All flaps allowed adequate and durable reconstruction to be achieved, with excellent contouring after 2-28 months of follow-up. CONCLUSIONS: The perforator-based stepladder V-Y advancement flap resulted in good outcomes for larger posterior heel defects compared with conventional transfer methods. The flap is a reliable, well-vascularized, sensate, and pliable local flap option that uses similar tissue from adjacent skin for defect repair and creates an internal gliding surface for the Achilles tendon.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tendón Calcáneo / Traumatismos de los Tejidos Blandos / Procedimientos de Cirugía Plástica / Colgajo Perforante Límite: Female / Humans / Male Idioma: En Revista: J Plast Reconstr Aesthet Surg Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tendón Calcáneo / Traumatismos de los Tejidos Blandos / Procedimientos de Cirugía Plástica / Colgajo Perforante Límite: Female / Humans / Male Idioma: En Revista: J Plast Reconstr Aesthet Surg Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos