Perforator pedicled propeller flaps for soft tissue coverage of the lower leg and foot defects

Objective To investigatethe clinical efficiency of perforator pedicled propeller flaps for soft tissue coverage of the lower leg and foot defects.Methods Twenty patients with soft tissue defects of the lower leg and foot were reviewed and evaluated retrospectively.The defects were repaired using the perforator pedicled propeller flaps from September 2011 to April 2013.There were 12 males and 8 females,with an average age of 45 years (range,5-75 years).Including 5 cases of injuries caused by the spokes and the Achilles heel of soft tissue defects,4 cases of infection after internal fixation of calcaneal fractures induced skin necrosis,2 cases of dorsal skin defects caused by heavy injured,9 cases of foot and ankle soft tissue defects caused by car accidents.The wounds and soft tissue defect area were from 2 cm × 8 cm to 5 cm × 20 cm.The course of disease was from 7 days to 60 days.These flaps included terminal branch of the peroneal artery perforator flap in 15 cases,posterior tibia artery perforator flap in 5 cases.The flap size ranged from 5 cm×ll cm to 7 cm×28 cm.The color Doppler ultrasound were used for the locating of all perforator vessel,the caliber diameter of the perforator artery ranged from 0.8 mm to 1.0 mm.Results The coincidence rate intraoperatively of the the color Doppler ultrasound was 96.7％.The donor sites were sutured directly in 12 cases and cured with skin-grafting in 8 cases.One case suffered from venous crisis in 24 hour was cured by the removal of part of the suture and bloodletting.All cases were followed up for 1 month to 18 months,and all flaps survived well and pedicle were smooth with a satisfied appearance.The patient were extremely satisfied with the results for repair.Conclusion The perforator pedicled propeller flap is a simple,without vascular anastomosis,safe and effective.Compared with other pedicle flap,it has more unique advantages for soft tissue coverage of the lower leg and foot defects. Key words: Surgical flaps;  Foot;  Ankle;  Soft tissue injuries