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Reverse sural flap with an adipofascial extension for reconstruction of soft tissue defects with dead spaces in the heel and ankle

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

The reconstruction of soft tissue defects with dead spaces in the heel and ankle is challenging. This article describes our experience in the reconstruction of such defects using the reverse sural flap with an adipofascial extension.

Method

Reverse sural flaps with an adipofascial extension were used in 26 patients with soft tissue defects in the heel (n = 24) or ankle (n = 2). Extended adipofascial tissue was utilized to fill the dead space. The sizes of the adipofascial extensions varied from 2.0 to 5.0 cm in length and 4.0 to 12.5 cm in width.

Result

Twenty-three flaps survived completely, and lateral marginal necrosis occurred in three flaps. All the recipient-site wounds healed without any signs of infection. The reconstruction outcomes were excellent in 20 patients and good in 6 patients according to the criteria of Boyden et al.

Conclusion

The extended adipofascial tissue of the reverse sural flap improves closure of the dead spaces in soft tissue defects of the heel and ankle and thus provides beneficial conditions for the treatment of infection and reconstruction of both the function and contour of the soft tissue defects with dead spaces in the heel and ankle.

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Acknowledgments

We thank Dr. Christina L. Kaufman and Dr. Alexander Hofmann for their help in reviewing and editing the manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopedics, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China

    L. Zheng & J. Zheng

  2. Christine M. Kleinert Institute for Hand and Microsurgery, Kleinert Kutz Hand Care Center, 225 Abraham Flexner Way, Suite 850, Louisville, KY, 40202, USA

    L. Zheng

  3. Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, 40202, USA

    L. Zheng

  4. Department of Orthopedics, the Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China

    Z. G. Dong

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  1. L. Zheng
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  2. J. Zheng
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  3. Z. G. Dong
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Corresponding author

Correspondence to L. Zheng.

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Conflict of interest

All authors declare that they have no conflict of interest.

Compliance with ethical requirements

This study was conducted in accordance with the Declaration of Helsinki. This study was conducted with approval from the Ethics Committee of Henan Provincial People’s Hospital. Written informed consent was obtained from all participants.

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Zheng, L., Zheng, J. & Dong, Z.G. Reverse sural flap with an adipofascial extension for reconstruction of soft tissue defects with dead spaces in the heel and ankle. Eur J Trauma Emerg Surg 42, 503–511 (2016). https://doi.org/10.1007/s00068-015-0569-x

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  • DOI: https://doi.org/10.1007/s00068-015-0569-x

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