[Repair of deep wounds of the foot and ankle].

OBJECTIVE

To summarize the clinical effects of the repairing methods for deep wounds of the foot and ankle.

METHODS

From March 2002 to June 2006, 49 patients with skin and deep tissue defects of the foot and ankle underwent the repairing treatment. Of them, 36 were males and 13 were females, aged 16 to 67 years( 39 years on average). The causes of injuries included mangled injury in 24 cases, high fall injury in 9 cases, cut injury in 7 cases, malignant soft tissue tumor in 5 cases, decubital ulcer in 2 cases, and electric burn in 2 cases. Of the 49 cases, 19 were in left side and 30 in right side. The defect size of skin ranged from 3 cm x 2 cm to 20 cm x 15 cm and deep tissue injuries were accompanied by defects of tendon and ligament in 24 cases, by damage of joint in 12 cases, and by bone defect in 9 cases, and 35 of them had infections, and 2 of them had diabetes of stage 2. The time between the injury and surgery ranged from 4 hours to 1 year. The wounds were repaired separately by local flap (3 cm x 3 cm to 6 cm x 4 cm) in 15 cases, local island flap(8 cm x 5 cm to 12 cm x 7 cm) in 25 cases, free flap (15 cm x 11 cm to 24 cm x 17 cm) in 4 cases, and cross leg flap(5 cm x 4 cm to 8 cm x 6 cm) in 5 cases. In 24 cases of defects of tendon and ligament, 15 underwent the reconstruction in one-stage operations, 9 in two-satge operation. In 9 cases accompanied by bone defect, two-stage bone grafting (12-64 g) was given after wound healed.

RESULTS

All of the 49 flaps survived. Forty-six healed by the first intention and 3 with distal edge necrosis healed after skin grafting. Two patients with sinus formation healed after 6-8 months of dressing change. All the cases were followed up 6 months to 3 years, and all the flaps were well developed, the functions of the foot and ankle were satisfactory.

CONCLUSION

It can get an excellent result of appearance and function recovery repairing deep wounds of the foot and ankle with proper flaps in earlier time.