The Clinical Curative Effect Of Sural Neurocutaneous Flap With Lateral Retromalleolar Perforator To Repair The Soft Tissue Defect In Foot And Ankle Wounds

Objective To explore the clinical curative effect of sural neurocutaneous flap with lateral retromalleolar perforator to repair the skin and soft tissue defect of foot and ankle.Methods The clinical data of 30 patients with exposure wounds on the foot and ankle treated by sural neurocutaneous flap with lateral retromalleolar perforator were analyzed retrospectively.From Jun.2010 to Jun.2016,male 21 cases,female 9 cases,age from 23 to 58,the average age of 40,all cases of soft tissue defect at foot and ankle were repaired with sural neurocutaneous flap with lateral retromalleolar perforator.The flap area was about 5cmx3cm~17cmx10cm.Postoperative anti-infection,anti-coagulation,anti-vascularspasm,symptomatic treatment.Results The operation of the thirty cases was successful,one case infect pseudomonas aeruginosa,which healed secondarily after dressing change,the rest 29 cases got primary healing.All flaps survived completely,no vessel crisis,flap donor area got primary healing.Five cases had partial necrosis at the distal part,which 3 cases healed secondarily after dressing change and 2 cases healed by free skin grafting.cases.Patients had been followed up for 3~24 months.The flaps were skin texture,colour and luster,good appearance,and patients could walk normally,but the flaps were insensitive.Six cases’ two-point discrimination were 10-12 mm,which anastomosed nerve.Two cases with lower limb fracture,fracture healing after half a year,and they could walk normally.The function of ankle plantar flexion and stretch recovered well.Conclusions The sural neurocutaneous flap with lateral retromalleolar perforator has the advantage of moving the pivot point to more distal region,and has reliable blood supply,the level is clear,simple operation,don’t need sacrifice the main artery,the survival rate is high,the little influence of calf function and appearance,to some extent they can restore some feeling,which is a good method to repair the soft tissue defect wound of foot and ankle.