Clinical application of lateral supramalleolar perforator flap with the rotation point down on the repair of forefoot soft tissue defect

Abstract

Objective To investigate the clinical effect of lateral supramalleolar perforator flap with the rotation point down on the repair of forefoot soft tissue defect. Methods From January, 2016 to June, 2017, 23 cases(15 males and 8 females) of forefoot soft tissue defect were repaired by lateral supramalleolar perforator flap with the rotation point down. The age ranged from 8 to 67 (mean, 42.9) years. The soft tissue defects were located far from the tarsometatarsal joint of the foot and the areas were 4.0 cm×4.0 cm-8.0 cm×12.0 cm. The areas of flap stitched directly or take blade thick skin repair on the thigh. All cases were followed-up by telephone or Internet, outpatient visit and home visit. Results Twenty-one cases survived successfully. Small area necrosis occurred at the distal end of the flap in 1 case, and healed after changing treatment. In the other cases, tension blister appeared at the distal end of the flap. After cut off some surgical stitches, the flap survived. All cases were followed-up from 6 to 12 months. The shape of flaps were not bloated and had good textures. The walking of affected limbs had no significant effect, and the functional recovery was satisfactory. Conclusion The lateral supramalleolar perforator flap is easy to cut and the perforator of flap is constant, which is a appropriate flap to repair the soft tissue defect of the forefoot. Key words: Lateral supramalleolar perforator flap; Rotation point; Forefoot; Soft tissue defect; Repair