Adipofacial Turn-Over Flap for Reconstruction of the Foot and Ankle.

Lee, Won Jai; Yang, Eun Jung; Tark, Kwan Chul; Chung, Yun Kyu

Search: J Korean Soc Plast Reconstr Surg Search

CLOSE

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(4):440-446.
Published online July 1, 2007.

Adipofacial Turn-Over Flap for Reconstruction of the Foot and Ankle.

Won Jai Lee, Eun Jung Yang, Kwan Chul Tark, Yun Kyu Chung

¹Department of Plastic and Reconstructive Surgery, Yonsei University, Wonju College of Medicine, Wonju, Korea. ykchung @yonsei.ac.kr
²Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Various kinds of local flap or free flap have been used for coverage for soft tissue defects with bone exposure over the ankle and dorsum of foot. Adipofascial flaps, nourished by vascular plexuses of the subcutaneous tissue and deep fascia originating from the local perforators of the major vessels, appear particularly to be indicated for the reconstruction of these areas. Our experience with this flap on the dorsum of foot and ankle has also been quite encouraging. METHODS: The design of the flap is determined by the size and the location of the defect. The base of the flap is chosen depending on the availability of the soft tissue around the defect. The ratio of the area of the flap to the area of the base wound be more reliable to predict the survival of the turnover flap by the conventional length-to-width ratio. Nineteen patients with defect over the dorsum of the foot and ankle were resurfaced with adipofascial turn-over flaps and skin graft.
RESULTS
The average age of the patients was 38.2 years(3-81 years). The flap size was from 2x3cm to 8x5cm. The average follow-up time was 6 months. All flaps survived completely except one case who suffered distal necrosis of the flap. The additional skin graft was required for partial skin loss in the five cases. Other functional impairment was not noted.
CONCLUSION
Dissection of the local adipofascial turnover flap is quite easy, quick, requires less time and sacrifice of surrounding muscle itself, and maintains major arteries. In most cases, donor-site morbidity is minimal with an acceptable scar, and both functional and esthetical results were satisfactory. Therefore, Adipofascial flap could be an option for the difficult wounds around the foot and ankle.

Keywords: Adipofascial turn-over flap; Foot reconstruction

TOOLS