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Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(3):352-357.
Published online May 1, 2007.
The Posterior Tibial Perforator Adipofascial Flap for Reconstruction of Lower Leg.
Seung Eun Hong, Jai Kyong Pyon
Department of Plastic and Reconstructive Surgery, Ewha Womans University School of Medicine, Seoul, Korea. pspriest@ewha.ac.kr
Abstract
PURPOSE
The coverage of distal soft tissue defects and bony exposure of the lower extremity has long been recognized to be difficult clinical problem. Covering with a local skin flap is usually impractical because of the extensive and deep crush, hence free flap has been used commonly for the coverage of the wound. Although it can provide good results, it has many disadvantages. Designing an adipofascial flap raised on perforating vessels of the posterior tibia artery is a reliable and simple method to perform, and it can solve these problems. METHODS: From May 2005 to May 2006, 8 patients underwent reconstruction of lower leg defects utilizing various type of the posterior tibial artery perforator adipofascial flaps. The flap provided a durable and thin coverage for the defect, as well as a well vascularized bed for skin grafting.
RESULTS
The flap size ranged 15-80cm(2), and skin graft was done for the recipient site. The flap were successfully used for the lower extremity reconstruction in most cases. Minor complications occurred in 4 cases. There was no functional disability of the donor site with esthetically pleasing results. Furthermore, these flaps were both easy to raise and insured sufficient arterial blood supply.
CONCLUSION
We believe there are many advantages to this posterior tibial artery perforator adipofascial flap and that it can be highly competitive to the free flaps in the lower extremity reconstruction.
Keywords: Posterior tibial artery; Lower leg reconstruction; Perforator flap
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