Objective To explore the clinical application of free and pedicled skin flaps in the repair of lower leg skin defects. Methods A retrospective analysis of 110 cases of lower leg skin defects repaired by skin flap from September 2017 to September 2020 were conducted. According to the type of skin flap, the patients were divided into a free group and a pedicled group. The intraoperative and postoperative conditions of the patients were analyzed respectively to understand the difference between the two groups of patients after receiving treatment. Results The operation time of the free group was longer than that of the pedicled group by more than 5 h, and the amount of intraoperative blood loss was more than that of the pedicled group （P<0.05）. In addition, the incidence rate of postoperative contractures in the free group was higher than that in the pedicled group, and the difference between the groups was statistically significant （P<0.05）. At the same time, the postoperative sensory recovery in the treated area of the lower leg was good in the two groups, with no big deviation. It could be seen from the survival curve that the flap survival rates of the two groups of patients were high, and the survival rate of the pedicled group was slightly higher than that of the free group. Conclusion Both flap repairing methods for lower leg skin defects are effective. Free flap is more adaptable, while pedicled flap is more manipulative and more effective.
CHEN Xingyuan
,
WU Junfu
,
ZHANG Shijin
,
YU Enting
. Application of free and pedicled skin flaps to repair lower leg skin defects[J]. Surgical Research and New Technique, 2022
, 11(1)
: 9
-13
.
DOI: 10.3969/j.issn.2095-378X.2022.01.002
[1] Ni Y, Ping L, Yang Z, et al.The application of fibular free flap with flexor hallucis longus in maxilla or mandible extensive defect: A comparison study with conventional flap[J]. World J Surg Oncol, 2018, 16(1):149.
[2] Wu M, Sun M, Dai H, et al.The application of keystone flap combined with vacuum-assisted closure in the repair of sacrococcygeal skin defect after tumor resection[J]. J Surg Oncol, 2019,119(7):974-978.
[3] Cui Z, Zhang X, Shou J, et al.Repeated reverse sural fasciocutaneous flap is an effective surgical strategy for repairing long segmental soft tissue defects of the tibia[J]. J Int Med Res, 2019, 47(10):5003-5009.
[4] 欧昌良,周鑫,罗旭超,等.腹壁下动脉穿支皮瓣修复小腿软组织缺损的临床应用[J].中华显微外科杂志,2018, 41(4):339-342.
[5] 马坪楠,邓永上,温文星,等.不同年龄段小腿皮肤软组织缺损患者应用腓动脉穿支筋膜蒂皮瓣修复临床资料的回顾性分析[J].河北医科大学学报,2018,39(11):1279-1282.
[6] Zhang C, Zeng Y, Zhou L, et al.The application of chimeric deep circumflex iliac artery perforator flap for oromandibular reconstruction: A case report[J].Medicine,2021,100(14):e25458.
[7] Azouz SM, Castel NA, Vijayasekaran A, et al.Lower‐limb reconstruction with chimeric flaps: The quad flap[J]. Microsurgery, 2018,39(2):182-187.
[8] Hayashida K,Saijo H,Fujioka M.Peroneal perforator‐based peroneus longus tendon and sural neurofasciocutaneous composite flap transfer for a large soft‐tissue defect of the forearm: A case report[J]. Microsurgery, 2018,38(1):85-88.
[9] Wang C, Yang W, Zhang F, et al.Superficial peroneal neurocutaneous flap for coverage of donor site defect after the combined transfer of toe and dorsal foot flap[J]. Ann Plas Surg, 2021, 86(4):440-443.
[10] Unluer Z, AL-Ajam Y, AL-Bema S.Functional outcome after reconstruction of traumatic soft tissue defects in the lower half of the leg with distally based medial hemisoleus muscle flaps: A case series and literature review[J]. Ann Plas Surg, 2018,81(4):468-471.
[11] Tsai PL, Ziegler OR, Sudario-Lumague R, et al.Reconstruction of tibia fracture with soft tissue defect[J]. Ann Plas Surg, 2020,86(25):S91-S95.
[12] Salmon PJ, Gunson TH, Ong S, et al.Bridge flap repair of the lower limb: A hybrid alternative to the keystone[J]. Australas J Dermatol , 2019, 60(3):224-227.
[13] Sawyer J, Boerum M, Groundland J, et al.Free tibia and fibula-fillet-of-leg flap for pelvic ring reconstruction: A case report[J]. Microsurgery, 2020, 40(6):492-496.
[14] Feng K, Sudirman SR, Shih H, et al.Experience on primary closure of fibular flap donor sites and development of an algorithm for closure based on different flap designs[J]. Microsurgery, 2020,40(7):741-749.
