Leg Perforator Flap For Foot And Ankle Soft Tissue Defects

Objectives: To explore the clinical effect and progress of leg perforator flap in repairing soft tissue defects of foot and ankle and prospect its possible research direction.Methods: The literature which was about basic research and clinical applications for calf perforator flap in repairing soft tissue defects of foot and ankle was reviewed. Choose the two commonly used kinds of leg perforator flap which were the medial supramalleolar perforator-based flap of posterior tibial artery and the lateral supramalleolor flap to be described respectively. The perforator branch was detected and earmarked by Doppler ultrasound.From August 2008 to December 2009, 6 patients with skin defects of the foot and ankle underwent the repairing treatment, of whom 4 were male and 1 was female, aged 30-65years, averaged 45 years. Of the 6 patients, 5 had a traffic accident and 1 had chronic ulcer with osteomyelitis.Flap covered the wound after a surgical debridement in 5cases, while 1 case dued to serious polluted wound was repaired after debridement to be anti-infection, medication and other treatment. Among them, 2 cases of soft-tissue defects of dorsal foot, 2 cases defects postero-heelstick, 1 case defects medial malleolus, and 1 case defects lateral malleolus, involving the exposure of tendons, bones or of foot. The medial supramalleolar perforator-based flap of posterior tibial artery was used in 2 patients and the lateral supramalleolor flap was used in 4 patients. The skin defects ranged in area of 4.0㎝×3.0㎝ to 8.0㎝×6.0㎝Results: All flaps survived well with no vascular crisis and infection and wound healing were stageⅠ. After 3 to 6 months follow up, the flaps were survival with color ruddy, good blood circulation, good flexibility and texture without pigmentation and good appearance.Conclusion: Calf perforator flap is an ideal flap in the repairing soft tissue defects of foot and ankle with the flexibility dissection and little effect on the appearance and function of donor site. To improve cardiovascular leg perforator flap axis positioning, strengthen basic research and clinical application of combination, and according to the different foot and ankle soft tissue defects in the wound situation, select the appropriate flap to achieve the best results, will be in the future research direction.