원위기적 표재성 비복동맥 도서형 근막피판을 이용한 족부 재건

Abstract

The human foot plays an important role in supporting the body when standing and walking. Soft tissue defects caused industrially or by car accidents may expose small joints and tendonds of the foot, therefore, reconstruction for proper coverage is very important. However, large soft tissue defect on the foot presents a challenging task due to poor circulation and lack choice for reconstruction for large soft tissue defects on the foot. Nevertheless, free flaps for the lower extremities continue to have the highest failure rates compared to other body regions. The distally based superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The artery gives off small branches to the skin in the lower two thirds of the leg. The artery anastomoses with septocutaneous branches from the peroneal artery. The advantages of this flap are as follows: 1. Easy and quick performance 2. More reliable blood sup fascia is included in the flap 3. Large flaps may be raised safely and the flaps are versatile 4. The arc of rotation is wide, therefore the flap may cover the nonweightbearing heel, Achilles tendon, malleoli, dorsum ankle, and weightbearing heel The authors have successfully elevaated 10 distally based superficial sural artery island flaps in reconstructing the soft tissue defect on the weightbearing heel, ankle, dorsum and nonweightbearing heel. The size of the flap ranged from 5×4cm to 12×7cm. All donor site defects were closed directly except 2 cases. The distally based superficial sural artery fasciocutaneous island flap appears to be an easy and useful alternative for reconstruction of the foot in selected patients.