Article
Harvesting the sural flap with covered pedicle: outcomes and advantages in 7 cases
Search Medline for
Authors
-
Alvaro Baik Cho
- IOTFMUSP, Grupo de Mao e Microcirurgia da FMABC, Santo André, Brazil
-
Carlos Henrique Vieira Ferreira
- Grupo de Cirurgia da Mao e Microcirurgia da FMABC, Santo André, Brazil
-
Priscilla Goes Medea De Mendonça
- Grupo de Cirurgia da Mao e Microcirurgia da FMABC, Santo André, Brazil
-
Luiz Sorrenti
- IOTFMUSP, Grupo de Mao e Microcirurgia da FMABC, Santo André, Brazil
-
Leandro Yoshinobu Kiyohara
- IOTFMUSP, Grupo de Mao e Microcirurgia da FMABC, Santo André, Brazil
| Published: | February 6, 2020 |
|---|
Outline
Text
Objectives/Interrogation: To evaluate the feasibility of harvesting the sural flap with a skin extension covering the pedicle, analysing the flap survival rate and the potential benefits of this modification
Methods: A prospective cohort of 7 consecutive cases were evaluated in terms of flap viability and the amount of skin graft required to cover the pedicle or donor site of the flap. Of these patients six were male and one female. 01 flap was performed for a tumor lesion, 01 for post-operative coverage of achilles tenorrhaphy and 5 for post-traumatic lesions. Seven patients were treated for soft tissue defects located at the middle third of the tibia, ankle or hindfoot. The flap design was exactly the same as described by Masquelet (1992). The only modification was the inclusion of a strip of skin (1 to 2 cm in width) over entire length of the dissected the pedicle, so the final shape of the flap was similar to a long racquet. After the flap elevation, the intermediary skin between the donor site and the soft-tissue defect was incised and the skin was undermined to accommodate the pedicle without any undue compression or tension. The flap was inset and sutured at the defect and the skin over the pedicle was also suture to the undermined skin
Results and Conclusions: All cases had a satisfactory evolution, with adequate healing of the wounds and flaps' integration. The donor site was primarily closed in all cases and a minimal amount of skin graft was required in 2 cases, at the base of the pedicle. In one patient the flap developed a superficial epidermolysis in the distal tip that healed by secondary intention without need for further intervention. The inclusion of a strip of skin covering the pedicle of the sural flap was feasible, without any technical issues. This modification did not negatively impact the survival rate of the flaps and provided an easier and safer accommodation for the flaps' pedicles, since none of the pedicles were tunneled. It also diminished the necessity for skin graft at the pedicle.
