Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort Study
Introduction: The foot and ankle serve as vital components in supporting mobility. When afflicted by trauma, infections, burns, or tumours, they often present challenging defects that expose tendons, bones, joints, and nerves. Managing softtissue reconstruction in this area is complex, primarily...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2023-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/18804/68210_CE[Ra1]_F(SL)_QC&REF(KK_IS)_PF1(AKA_DK_OM)_PFA(AKA_KM)_PN(KM).pdf |
| _version_ | 1827582525846847488 |
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| author | Priti Upadhyay Sandip Basu |
| author_facet | Priti Upadhyay Sandip Basu |
| author_sort | Priti Upadhyay |
| collection | DOAJ |
| description | Introduction: The foot and ankle serve as vital components
in supporting mobility. When afflicted by trauma, infections,
burns, or tumours, they often present challenging defects that
expose tendons, bones, joints, and nerves. Managing softtissue reconstruction in this area is complex, primarily due to
limited local tissue resources and inadequate muscle coverage.
A range of reconstructive options exists, encompassing local,
locoregional, and distant flaps, with microvascular free flaps as
the gold standard. Recent studies have explored newer pedicled
and perforator-based flaps as promising alternatives for lower
extremity soft-tissue defects.
Aim: To explore the efficacy of perforator-based local and
locoregional flaps for resurfacing peri-ankle defects.
Materials and Methods: This prospective cohort study was
conducted at the Department of Plastic Surgery, SSKM Hospital,
and IPGME&R, Kolkata, West Bengal, India, from April 2019
to March 2022. A total of 49 patients with soft-tissue defects
around the ankle were included. The reconstructive approach
primarily involved perforator-based flaps from various arterial
sources. Outcomes were categorised as complete defect
coverage, minor flap necrosis without intervention, or major
necrosis necessitating additional surgical intervention. For this
descriptive study, proportion was used to compare categorical
variables such as the number of cases with different aetiology,
and the number of different flaps used were compared. For the
continuous variable like age, mean has been used as a measure
of central tendency.
Results: The mean age of the study population was 39.6±4.1
years. Thirty-four out of 49 patients (69.38%) presented with
defects stemming from Road Traffic Accidents (RTA), and the
posterior aspect of the ankle was the most common defect
location (14 out of 49 patients, 28.57%). Peroneal Artery
Perforator Flaps (PAPF) exhibited the highest success rate,
with 18 out of 20 cases where this flap was used (90%), closely
followed by Lateral Supramalleolar Flaps (LSF), with 13 out of
15 cases (86.7%). Overall, in 42 out of 49 cases (85.7%), the
perforator-based flaps effectively resurfaced the defects.
Conclusion: Pedicled perforator-based flaps, including those
based on the peroneal artery and lateral supramalleolar, have
emerged as valuable options for the reconstruction of softtissue defects around the ankle. |
| first_indexed | 2024-03-08T22:53:02Z |
| format | Article |
| id | doaj.art-ee77302c9050478a94bb9db0358028ee |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-08T22:53:02Z |
| publishDate | 2023-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-ee77302c9050478a94bb9db0358028ee2023-12-16T09:16:31ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-12-011712010410.7860/JCDR/2023/68210.18804Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort StudyPriti Upadhyay0Sandip Basu1Senior Resident (Former), Department of Plastic Surgery, IPGME&R/SSKM Hospital, Kolkata, West Bengal, India.Associate Professor, Department of Plastic Surgery, IPGME&R/SSKM Hospital, Kolkata, West Bengal, India.Introduction: The foot and ankle serve as vital components in supporting mobility. When afflicted by trauma, infections, burns, or tumours, they often present challenging defects that expose tendons, bones, joints, and nerves. Managing softtissue reconstruction in this area is complex, primarily due to limited local tissue resources and inadequate muscle coverage. A range of reconstructive options exists, encompassing local, locoregional, and distant flaps, with microvascular free flaps as the gold standard. Recent studies have explored newer pedicled and perforator-based flaps as promising alternatives for lower extremity soft-tissue defects. Aim: To explore the efficacy of perforator-based local and locoregional flaps for resurfacing peri-ankle defects. Materials and Methods: This prospective cohort study was conducted at the Department of Plastic Surgery, SSKM Hospital, and IPGME&R, Kolkata, West Bengal, India, from April 2019 to March 2022. A total of 49 patients with soft-tissue defects around the ankle were included. The reconstructive approach primarily involved perforator-based flaps from various arterial sources. Outcomes were categorised as complete defect coverage, minor flap necrosis without intervention, or major necrosis necessitating additional surgical intervention. For this descriptive study, proportion was used to compare categorical variables such as the number of cases with different aetiology, and the number of different flaps used were compared. For the continuous variable like age, mean has been used as a measure of central tendency. Results: The mean age of the study population was 39.6±4.1 years. Thirty-four out of 49 patients (69.38%) presented with defects stemming from Road Traffic Accidents (RTA), and the posterior aspect of the ankle was the most common defect location (14 out of 49 patients, 28.57%). Peroneal Artery Perforator Flaps (PAPF) exhibited the highest success rate, with 18 out of 20 cases where this flap was used (90%), closely followed by Lateral Supramalleolar Flaps (LSF), with 13 out of 15 cases (86.7%). Overall, in 42 out of 49 cases (85.7%), the perforator-based flaps effectively resurfaced the defects. Conclusion: Pedicled perforator-based flaps, including those based on the peroneal artery and lateral supramalleolar, have emerged as valuable options for the reconstruction of softtissue defects around the ankle.https://www.jcdr.net/articles/PDF/18804/68210_CE[Ra1]_F(SL)_QC&REF(KK_IS)_PF1(AKA_DK_OM)_PFA(AKA_KM)_PN(KM).pdfposterior aspect anklepedicled flapsmicrovascular flapsreconstructionresurfacing of wound |
| spellingShingle | Priti Upadhyay Sandip Basu Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort Study Journal of Clinical and Diagnostic Research posterior aspect ankle pedicled flaps microvascular flaps reconstruction resurfacing of wound |
| title | Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort Study |
| title_full | Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort Study |
| title_fullStr | Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort Study |
| title_full_unstemmed | Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort Study |
| title_short | Efficacy of Locoregional Perforator Flaps for Resurfacing of Peri-ankle Soft Tissue Defects: A Single Centre Prospective Cohort Study |
| title_sort | efficacy of locoregional perforator flaps for resurfacing of peri ankle soft tissue defects a single centre prospective cohort study |
| topic | posterior aspect ankle pedicled flaps microvascular flaps reconstruction resurfacing of wound |
| url | https://www.jcdr.net/articles/PDF/18804/68210_CE[Ra1]_F(SL)_QC&REF(KK_IS)_PF1(AKA_DK_OM)_PFA(AKA_KM)_PN(KM).pdf |
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