Anterolateral Skin Flap Research Articles

Modified retrograde femoral anterolateral flap with a dual blood supply for complex destruction wound in calf

Objective To evaluate the clinical efficacy of retrograde femoral anterolateral skin flap with a dual blood supply for repairing complex destruction wound in calf. Methods From July 2011 to March 2014, 6 patients with destructive wound in calf were treated by modified retrograde femoral anterolateral flaps with a dual blood supply. The patients aged 25-56 years consisted of 4 males and 2 females. There were 4 patients with traffic injury and 2 machine crush injury. Wound ranged from 8 cm×10 cm to 10 cm×26 cm. Pedicle retrograde femoral anterolateral flap supplied by high cutaneous branches was harvested to cover the wound. Based on the principle ofbooster, flap blood flow was increased by anastomosis between lateral femoral circumflex artery and calf arteriovenous after 180 ° rotation of the skin flap. Results Flaps all survived. Markedly swollen flap was seen in 2 patients postoperatively, which impeded venous return, but significantly improved after stitches removal on one side of the flap. One-stage healing occurred in 3 patients. Good wound healing was noted in 2 patients while swelling subsided and secondary suture was done. Postoperative infection occurred in 1 patient and after debridement and dressing, the wound was finally healed. Two patients had scalded skin flap due to the careless two months after operation and healed after dressing. Follow-up lasted for 6 to 22 months with no delayed recurrent infection, myelitis and bone nonunion. Conclusion Retrograde femoral anterolateral flap with a dual blood supply may be a good option for wound repair of severe calf injury because of its normal appearance, good texture, long vascular pedicle, large surface area, high survival rate, improved flap blood supply and strong resistance to infection. Key words: Soft tissue injuries; Surgical flaps; Calf

Clinical appfications of the anterolateral skin flap in the lower leg and the reversed superficial peronealneurocutaneous island flap

Objective To investigate the anatomy and clinical effect of the anterolateral skin flap in the lower leg and the reversed superficial pereneal neuracutaneous island flap. Methods Seven cases of hand skin defect were treated with anterolateral skin flap in the lower leg with vascular anastomosis. 7 cases of ankle soft tissue loss were repaired with reversed superficial peroneal neurocutaneous island flap. 4 cases of the tissue defects in the middle and proximal parts of the leg and 13 cases of the tissue defects in the middle and distal parts of the leg were repaired with sequential superficial peroneal artery island flap and combined flap of super-ficial peroneal artery island flap and superficial peroneal neurocutaneous island flap respectively. Results Seven cases of the anterolateral skin flap in the lower leg with vascular anastomosis, 4 cases of the sequential superficial peroneal artery island flap and 13 cases of the combined flap of superficial peroneal artery island flap and superficial peroneal neurocutaneous island flap were survived.Becanse of vein drainage disturbance which led to partial necrosis of flap, one case of the reversed superficial peroneal neurocutaneous island flap was de-layed healing with epluehage and skin grafting. Conclusion The anterolateral skin flap in the lower leg and the reversed superficial peroneal neurocutaneous island flap compensate each other anatomically. The operation based on the anatomy enlarges the size of the flap and extends the scope of reconstruction. Key words: Anterotateral flap of lowerleg; Superficial peroneal nerve; Transplantation; Micro-surgery