[Clinical application of sural fasciomyocutaneous perforator flap in repair of soft tissue defect in weight-bearing area of foot].

OBJECTIVE

To assess the effectiveness of the sural fasciomyocutaneous perforator flap in repair of soft tissue defect in weight-bearing area of the foot.

METHODS

Between January 2007 and September 2010, 19 patients with soft tissue defects in the weight-bearing area of the foot were treated with sural fasciomyocutaneous perforator flaps. The etiology was traffic accident in 16 patients and crush injury in 3 patients. The interval of injury and admission was 2 hours to 14 days. The size of defect ranged from 8 cm x 6 cm to 26 cm x 16 cm; the size of flap ranged from 7 cm x 7 cm to 25 cm x 12 cm. The donor sites were repaired by free skin graft. The flap survival was observed after operation, and the pain score and sensory recovery at the recipient site were used to assess the effectiveness.

RESULTS

The flaps survived with satisfactory aesthetic and functional results in 18 cases. Partial flap necrosis was noted and second healing was achieved after split thickness skingrafting in 1 case. One case of delayed ulceration was also noted after 5 weeks, ulceration was successfully cured after wound care and avoidance of weight-bearing for 2 weeks. All patients were followed up 9-25 months (mean, 14.1 months). The flaps had good appearance, without bulky pedicle. Superficial sensation and deep sensation were restored in 17 cases (89.4%) and 18 cases (94.7%) respectively at last follow-up.

CONCLUSION

Sural fasciomyocutaneous perforator flap is a reliable modality in heel reconstruction, having the advantages of low ulceration rate, good wear resistance, and good sensation recovery.