Xu Gong1, Laijin Lu, Leigang Li. 1. Department of Hand Surgery, First Hospital of Jilin University, Changchun Jilin, 130021, PR China.
Abstract
OBJECTIVE: To explore a suitable repairing method for skin defects of the foot and ankle, and to evaluate the therapeutic effects of the different repairing methods. METHODS: From January 2000 to October 2005, 36 patients with skin defects of the foot and ankle underwent the repairing treatment, of whom 35 were males and 1 was patients with skin defects of the foot and ankle underwent the repairing treatment, of whom 35 were males and 1 was 2 repaired groups. And the patients in the 2 groups were equally satisfied with the repairing treatments. female, aged 5-62 years, averaged 38 years. Of the 36 patients, 12 had an injury by a machine, 22 had a traffic accident, 1 had an infection, and 1 had a cold injury. And the injuries involved the dorsum of the foot, heel, forefoot, and medial or lateral malleolus. The injuries were respectively treated by 2 different repairing methods, the repair with the coverage by the lateral supramalleolar flaps and the repair with the coverage by the reverse sural neurocutaneous flaps. The skin defects ranged in area from 5 cm x 4 cm to 20 cm x 10 cm. The lateral supramalleolar flap was used in 15 patients (15 flaps) with a flap area of 5 cm x 4 cm-15 cm x 8 cm, and the reverse sural neurocutaneous flap was used in 21 patients (22 flaps) with a flap area of 6 cm x 4 cm-20 cm x 10 cm. We retrospectively observed the therapeutic results and compared the success rates of the two methods. RESULTS: Of the 36 patients, 15 underwent the repair with the coverage by 15 lateral supramalleolar flaps; 10 achieved a complete survival of the flaps, 2 developed an epidermal necrosis over the distal part, and 3 developed a complete necrosis. The other 21 patients underwent the repair with the coverage by 22 reverse sural neurocutaneous flaps. Of the 22 flaps, 21 had a complete survival, and only 1 failed to coverage by 22 reverse sural neurocutaneous flaps. Of the 22 flaps, 21 had a complete survival, and only 1 failed to survive. The comparison revealed that there was no difference in the color, texture, and contour of the flaps between the 2 repaired groups. And the patients in the 2 groups were equally satisfied with the repairing treatments. The sensation of the flaps recovered to S0-S1. CONCLUSION: The repairing of the foot and ankle skin defects with the coverage by the lateral supramalleolar flaps or by the reverse sural neurocutaneous flaps can achieve a similar good therapeutic result. However, the repair with the lateral supramalleolar flaps is more suitable for the skin defect of a smaller area over the medial or lateral malleolus, or the proximal dorsum of the foot; the repair with the reverse sural neurocutaneous flaps is more suitable for the skin defect of a larger area over the foot and ankle without serious destruction of the malleolar arterial rete.
OBJECTIVE: To explore a suitable repairing method for skin defects of the foot and ankle, and to evaluate the therapeutic effects of the different repairing methods. METHODS: From January 2000 to October 2005, 36 patients with skin defects of the foot and ankle underwent the repairing treatment, of whom 35 were males and 1 was patients with skin defects of the foot and ankle underwent the repairing treatment, of whom 35 were males and 1 was 2 repaired groups. And the patients in the 2 groups were equally satisfied with the repairing treatments. female, aged 5-62 years, averaged 38 years. Of the 36 patients, 12 had an injury by a machine, 22 had a traffic accident, 1 had an infection, and 1 had a cold injury. And the injuries involved the dorsum of the foot, heel, forefoot, and medial or lateral malleolus. The injuries were respectively treated by 2 different repairing methods, the repair with the coverage by the lateral supramalleolar flaps and the repair with the coverage by the reverse sural neurocutaneous flaps. The skin defects ranged in area from 5 cm x 4 cm to 20 cm x 10 cm. The lateral supramalleolar flap was used in 15 patients (15 flaps) with a flap area of 5 cm x 4 cm-15 cm x 8 cm, and the reverse sural neurocutaneous flap was used in 21 patients (22 flaps) with a flap area of 6 cm x 4 cm-20 cm x 10 cm. We retrospectively observed the therapeutic results and compared the success rates of the two methods. RESULTS: Of the 36 patients, 15 underwent the repair with the coverage by 15 lateral supramalleolar flaps; 10 achieved a complete survival of the flaps, 2 developed an epidermal necrosis over the distal part, and 3 developed a complete necrosis. The other 21 patients underwent the repair with the coverage by 22 reverse sural neurocutaneous flaps. Of the 22 flaps, 21 had a complete survival, and only 1 failed to coverage by 22 reverse sural neurocutaneous flaps. Of the 22 flaps, 21 had a complete survival, and only 1 failed to survive. The comparison revealed that there was no difference in the color, texture, and contour of the flaps between the 2 repaired groups. And the patients in the 2 groups were equally satisfied with the repairing treatments. The sensation of the flaps recovered to S0-S1. CONCLUSION: The repairing of the foot and ankle skin defects with the coverage by the lateral supramalleolar flaps or by the reverse sural neurocutaneous flaps can achieve a similar good therapeutic result. However, the repair with the lateral supramalleolar flaps is more suitable for the skin defect of a smaller area over the medial or lateral malleolus, or the proximal dorsum of the foot; the repair with the reverse sural neurocutaneous flaps is more suitable for the skin defect of a larger area over the foot and ankle without serious destruction of the malleolar arterial rete.