The Feasibility And Prognosis Of Repairing Soft Tissue Defects In Children’s Foot And Ankle Using Sural Neurovascular Skin Flaps

The aver Objectives:To explore the feasibility and prognosis of repairing soft tissue defects in children’s foot and ankle using sural neurovascular skin flaps and prospect the possible research direction.Methods:The literatures in recent years about the basic research and clinical applications of sural neurovascular skin flaps for repairing soft tissue defects in foot and ankle were reviewed. The commonly used crus sural neurovascular skin flaps, namely sural neurovascular fascia pedicle flaps, used for repairing soft tissue defects in children’s foot and ankle were explained. The perforator branch was detected and earmarked by Doppler ultrasound before operation.37children with soft tissue defects in foot and ankle were collected from November2006to July2013in department of orthopedics in Weihai People’s Hospital. After mentioning illness and treatment schedule for patients’ parents without any emotional and suggested tendencies,27children were received repairing soft tissue defects in children’s foot and ankle with sural neurovascular skin flaps.10children were included control group and received VSD pressure suction in period Ⅰ and free skin grafting in period ⅡResults:All cases in skin flaps transfer group were totally survival without vascular crisis and infection and all wounds healed in period Ⅰ.age hospitalization time was17days. No operation was performed. Patients left hospital bearing load except12patients with fracture. Activity area of ankle was good. The flaps had good blood circulation and satisfactory elasticity, and no hyperpigmentation by follow-up of3-6months. In control group,6patients’ wounds healed after2operations and2patients received4operations. All patients left hospital without bearing load. Activity area of ankle was limited. All cases were totally survival,3cases had bad elasticity and3cases had limited activity area of ankle and bad appearance by follow-up of3-6months.Conclusion:Crus sural neurovascular skin flaps is a comparative desirable method to repair soft tissue defects in children’s foot and ankle, for it’s convenient in design and little influence to function and appearance of donor area. The research directions in the future was to improve the status of crus sural neurovascular skin flaps, strengthen the combination of basic research and clinical application, choose flaps with appropriate size to reach the optimal effects of the wound repair according to the condition of different soft tissues defect in foot and ankle.