Modified Anterior Tibial Artery Perforator‐Pedicled Propeller Flap for Soft‐Tissue Coverage of the Ankle and Heel

Abstract

Background The ankle and heel are challenging regions to reconstruct functionally. Here, we explored the feasibility and clinical outcomes of a modified anterior tibial artery perforator‐pedicled propeller flap for the repair of soft‐tissue defects of the ankle and heel. Patients and methods Between January 2013 and December 2015, 12 patients with soft‐tissue defects of the ankle and/or heel underwent reconstructive surgery that included our flap technique. The flaps measured 20 × 8 cm to 7 × 4 cm. A hand‐held Doppler was used to identify a proper constant perforator in the distal ankle. In each case, the base of the flap was well preserved. The flap was transposed (180° rotation) to reach and cover the defect. Results The average follow‐up time was 13 months (10–28 months). We observed good texture matches and contour in all of the flaps. All patients could walk and wear normal footwear. All but one flap survived completely without complications. Partial loss was observed in one patient, and the necrotic region was healed with secondary intention. Conclusion Our modified anterior tibial artery free‐style perforator‐pedicled propeller flap provides a novel option for functional ankle and heel reconstruction. Level of Evidence Level IV.

Protective effects of sodium ferulate on flap transplantation via anti-inflammatory modulation and oxidative stress inhibition

“…Flap transplantation is the main modality in wound repair and reconstructive surgery, and partial ischemia and necrosis of the flap is the most common complication in reconstructive surgery ( 1 ). Inadequate hemoperfusion and ischemia-reperfusion injury (IRI) after transplantation are considered to be the major cause of flap necrosis and failure ( 2 , 3 ).…”

Exploring the Long-Term Efficacy and Surgical Outcomes of Sural Neurovascular Flap Applications in Distal Lower Limb Wound Reconstruction: A Single-Center Retrospective Study

“…In contrast, Korompilias et al documented a protracted healing period averaging over three weeks, possibly attributable to challenges posed by diabetes and smoking, and excluding patients with comorbidities such as diabetes and hypertension yielded relatively favorable healing outcomes, underscored by the high ap survival rates. Although studies on preoperative recipient site condition effects on wound healing remain scarce, variations in wound healing between diabetic and non-diabetic patients have been delineated [1,5]. The recipient site's condition emerges as pivotal to procedural success, thus accentuating the indispensable role of thorough debridement in averting complications like infections.…”

“…Various surgical procedures have been investigated to overcome these issues, with the sural neurovascular aps emerging as a potential option. [4][5][6][7][8] The sural neurovascular ap, encompassing the sural nerve and surrounding arteries, has emerged as a viable option, offering consistent vascularity and exibility in ap design [2,[9][10][11]. This ap provides robust soft tissue coverage while preserving functional integrity, making it ideal for reconstructive surgery in the ankle and foot areas [1,3,9,[12][13][14][15][16][17].…”

Three‐Dimensional Digitalized Virtual Planning of Free Anterior Tibial Artery Perforator Flap for Repairing Soft Tissue Defects in Extremities

“…However, the above studies were based on autopsy, color latex perfusion, Doppler ultrasound, and other traditional methods. The origin, course, location, diameter, and length of the perforator were not fully elucidated, thus limiting the design and application of the free anterior tibial artery perforator flap [4, 5]. In recent years, some scholars have designed and dissected bones or flaps with computer‐assisted technology, which has significantly improved graft survival and reconstruction accuracy [6, 7].…”