Application of selectively thinning of free anterolateral thigh flap in repair of heel skin and soft tissue defect_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Qian ,  XIAO Haitao ,  CEN Ying

Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

XIAO Haitao, Email: xhaitao@163.com; CEN Ying, Email: cenying0141@163.com

Keywords：

Anterolateral thigh flap; thinning flap; heel; wound repair

DOI：

10.7507/1002-1892.201710074

Video：

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ObjectiveTo investigate the effectiveness of selectively thinning of the free anterolateral thigh flap in repair of the heel skin and soft tissue defect.MethodsBetween April 2013 and August 2015, 8 patients with tissue defect of heel caused by different reasons were recruited. There were 6 males and 2 females with an average age of 31.2 years (range, 15-49 years). The size of wound ranged from 14 cm×10 cm to 19 cm×14 cm. All the wounds were repaired with the contralateral free anterolateral thigh flap. The partial flap which was going to repair the defects of the heel and non-weight-bearing area of planta pedis was selectively thinned. The size of flap ranged from 14 cm×10 cm to 19 cm×14 cm. The donate site was repaired by skin grafting.ResultsAll flaps survived after operation, and wounds healed by first intention. The marginal necrosis of skin graft occurred in 2 cases, and healed after changing the dressing. The other skin grafts survived. All patients were followed up 8-20 months (mean, 12.3 months). All patients could walk normally. During follow-up, 2 flaps were injured and cured after symptomatic management. The appearance of flap was good in 7 cases with no influence in wearing shoes. Only 1 patient received the second-stage surgery of thinning the flap after 1 year.ConclusionApplication of the selectively thinning of the free anterolateral thigh flap can repair the heel skin and soft tissue defects, and achieve an ideal appearance and function.

Citation： LI Qian, XIAO Haitao, CEN Ying. Application of selectively thinning of free anterolateral thigh flap in repair of heel skin and soft tissue defect. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(3): 350-353. doi: 10.7507/1002-1892.201710074 Copy

1.	藺海龍, 田寶祥, 劉鳳彬, 等. 足底內側動脈皮瓣修復足跟部嚴重凍傷創面 15 例. 中華燒傷雜志, 2014, 30(3): 282-283.
2.	Kharmandayan V, Harada MN, Anacleto ACF, et al. Weight-bearing plantar reconstruction after resection of melanoma using the medial plantar flap. Plast Reconstr Surg, 2015,136(4S): 166-167.
3.	周曉, 薛明宇, 芮永軍, 等. 帶外踝后腓動脈穿支的 V-Y 推進皮瓣修復兒童足跟后區較小創面. 中華整形外科雜志, 2015, 31(4): 288-291.
4.	唐修俊, 王波, 魏在榮, 等. 保留感覺的脛后動脈穿支皮瓣 V-Y 推進修復踝周創面. 中國修復重建外科雜志, 2015, 29(12): 1515-1518.
5.	楊英才, 孫振忠, 張重陽, 等. 以脛后動脈為蒂的逆行島狀皮瓣并聯脛骨瓣修復足跟皮膚及跟骨缺損. 中華整形外科雜志, 2015, 31(2): 143-144.
6.	巨積輝, 金光哲, 劉躍飛, 等. 小兒足跟部復合組織缺損的皮瓣修復. 中華小兒外科雜志, 2012, 33(3): 238-240.
7.	董福, 朱金榮, 李云峰, 等. 序貫封閉式負壓引流技術與帶蒂皮瓣治療兒童后足摩托車輪輻傷. 中國修復重建外科雜志, 2015, 29(4): 462-466.
8.	唐修俊, 魏在榮, 王波, 等. 游離股前外側皮瓣修復四肢皮膚軟組織缺損 22 例. 中華燒傷雜志, 2015, 31(4): 308-310.
9.	趙勇剛, 楊銘華, 郭德華, 等. 四種游離皮瓣修復前足及足底軟組織缺損. 中華顯微外科雜志, 2014, 37(2): 193-194.
10.	尹路, 宮可同, 殷中罡, 等. 游離穿支皮瓣聯合游離植皮修復足踝部軟組織缺損的療效觀察. 中國修復重建外科雜志, 2017, 31(3): 319-322.
11.	曹廣超, 鄭大偉, 孫峰, 等. 預構感覺皮瓣修復足跟軟組織撕脫傷. 中國修復重建外科雜志, 2015, 29(2): 198-201.
12.	Furukawa M, Nakagawa K, Hamada T. Long-term complications of reconstruction of the heel using a digitorum brevis muscle flap. Ann Plast Surg, 1993, 30(4): 354-358.
13.	Malhotra K, Lian TS, Chakradeo V. Vascular anatomy of anterolateral thigh flap. Largngoscope, 2008, 118(4): 589-592.
14.	張文亞, 伍輝國, 胡玉祥, 等. 修薄股前外側皮瓣游離移植修復足踝部軟組織缺損. 中華顯微外科雜志, 2011, 34(5): 400-401.
15.	Kuran I, Turgut G, Bas L, et al. Comparison between sensitive and nonsensitive free flaps in reconstruction of the heel and plantar area. Plast Reconstr Surg, 2000, 105(2): 574-580.
16.	唐舉玉, 李康華, 謝松林, 等. 股前外側皮瓣修復足跟大面積軟組織缺損的感覺重建探討. 中華顯微外科雜志, 2012, 35(4): 267-271.

1. 藺海龍, 田寶祥, 劉鳳彬, 等. 足底內側動脈皮瓣修復足跟部嚴重凍傷創面 15 例. 中華燒傷雜志, 2014, 30(3): 282-283.
2. Kharmandayan V, Harada MN, Anacleto ACF, et al. Weight-bearing plantar reconstruction after resection of melanoma using the medial plantar flap. Plast Reconstr Surg, 2015,136(4S): 166-167.
3. 周曉, 薛明宇, 芮永軍, 等. 帶外踝后腓動脈穿支的 V-Y 推進皮瓣修復兒童足跟后區較小創面. 中華整形外科雜志, 2015, 31(4): 288-291.
4. 唐修俊, 王波, 魏在榮, 等. 保留感覺的脛后動脈穿支皮瓣 V-Y 推進修復踝周創面. 中國修復重建外科雜志, 2015, 29(12): 1515-1518.
5. 楊英才, 孫振忠, 張重陽, 等. 以脛后動脈為蒂的逆行島狀皮瓣并聯脛骨瓣修復足跟皮膚及跟骨缺損. 中華整形外科雜志, 2015, 31(2): 143-144.
6. 巨積輝, 金光哲, 劉躍飛, 等. 小兒足跟部復合組織缺損的皮瓣修復. 中華小兒外科雜志, 2012, 33(3): 238-240.
7. 董福, 朱金榮, 李云峰, 等. 序貫封閉式負壓引流技術與帶蒂皮瓣治療兒童后足摩托車輪輻傷. 中國修復重建外科雜志, 2015, 29(4): 462-466.
8. 唐修俊, 魏在榮, 王波, 等. 游離股前外側皮瓣修復四肢皮膚軟組織缺損 22 例. 中華燒傷雜志, 2015, 31(4): 308-310.
9. 趙勇剛, 楊銘華, 郭德華, 等. 四種游離皮瓣修復前足及足底軟組織缺損. 中華顯微外科雜志, 2014, 37(2): 193-194.
10. 尹路, 宮可同, 殷中罡, 等. 游離穿支皮瓣聯合游離植皮修復足踝部軟組織缺損的療效觀察. 中國修復重建外科雜志, 2017, 31(3): 319-322.
11. 曹廣超, 鄭大偉, 孫峰, 等. 預構感覺皮瓣修復足跟軟組織撕脫傷. 中國修復重建外科雜志, 2015, 29(2): 198-201.
12. Furukawa M, Nakagawa K, Hamada T. Long-term complications of reconstruction of the heel using a digitorum brevis muscle flap. Ann Plast Surg, 1993, 30(4): 354-358.
13. Malhotra K, Lian TS, Chakradeo V. Vascular anatomy of anterolateral thigh flap. Largngoscope, 2008, 118(4): 589-592.
14. 張文亞, 伍輝國, 胡玉祥, 等. 修薄股前外側皮瓣游離移植修復足踝部軟組織缺損. 中華顯微外科雜志, 2011, 34(5): 400-401.
15. Kuran I, Turgut G, Bas L, et al. Comparison between sensitive and nonsensitive free flaps in reconstruction of the heel and plantar area. Plast Reconstr Surg, 2000, 105(2): 574-580.
16. 唐舉玉, 李康華, 謝松林, 等. 股前外側皮瓣修復足跟大面積軟組織缺損的感覺重建探討. 中華顯微外科雜志, 2012, 35(4): 267-271.

Chinese Journal of Reparative and Reconstructive Surgery

Application of selectively thinning of free anterolateral thigh flap in repair of heel skin and soft tissue defect

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