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Reconstruction of Lateral Malleolar Defects: Adipofascial Turnover Flap Based on the Peroneal Artery Perforator

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Author(s)
Hyeonjung YeoSanghun LeeHyochun ParkHannara ParkHyodong KimDaegu Son
Keimyung Author(s)
Son, Dae Gu
Department
Dept. of Plastic Surgery (성형외과학)
Journal Title
J Wound Manag Res
Issued Date
2022
Volume
18
Issue
1
Keyword
Surgical flapsPerforator flapReconstructive surgical proceduresLower extremity
Abstract
Background:
Lateral malleolar defects are a commonly encountered clinical issue, with several treatment options available from local flaps to microsurgical reconstruction. However, ankle defects are difficult to manage, especially in patients with comorbidities. We report here our experience of lateral malleolar reconstruction using adipofascial turnover flaps based on the peroneal artery perforator.

Methods:
A total of nine patients who underwent peroneal artery perforator-based adipofascial turnover flap coverage from December 2011 to February 2016 were retrospectively evaluated. Data were collected on the patients' age, sex, etiology, comorbidities, anesthesia type, combined surgery, presence of osteomyelitis, bacterial profiles, vascular status, defect size, flap size, flap elevation time, follow-up period, and complications.

Results:
The mean age of the patients was 66.4 years. The most common cause of the wound was pressure injury. Seven patients had one or more comorbidities, and four patients were current smokers. Three patients were diagnosed with chronic osteomyelitis. Percutaneous transluminal angioplasty was performed in two patients. The mean defect size was 8.4 cm2, and the mean follow-up period was 30.7 months. All nine flap transfers were successful without major complications. However, in one case, partial skin graft loss occurred, requiring additional skin grafting.

Conclusion:
The peroneal artery perforator-based adipofascial turnover flap is a safe and reliable method to reconstruct lateral malleolar defects. The operative technique is simple and convenient to perform and hence a useful option for reconstructing lateral malleolar defects. This is especially true for patients with comorbidities who are typically not indicated for more complex procedures.
Keimyung Author(s)(Kor)
손대구
Publisher
School of Medicine (의과대학)
Citation
Hyeonjung Yeo et al. (2022). Reconstruction of Lateral Malleolar Defects: Adipofascial Turnover Flap Based on the Peroneal Artery Perforator. J Wound Manag Res, 18(1), 23–30. doi: 10.22467/jwmr.2021.01844
Type
Article
ISSN
2586-0410
Source
https://www.jwmr.org/journal/view.php?doi=10.22467/jwmr.2021.01844
DOI
10.22467/jwmr.2021.01844
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44085
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Plastic Surgery (성형외과학)
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