Risk factors related to the partial necrosis of the posterior tibial artery perforator-plus fasciocutaneous flap

Abstract

Purpose and background

The posterior tibial artery perforator-plus fasciocutaneous (PTAPF) flap is commonly used for defects over the distal lower extremity. However, the causes of partial necrosis of the PTAPF flap are unknown. This paper aimed to explore the factors related to the partial necrosis of the PTAPF flap.

Methods

A retrospective study was conducted on 59 patients who received the PTAPF flap for soft-tissue defects between September 2007 and September 2017. The clinical outcomes of the flap were evaluated, and the patient and surgical factors related to flap survival were analyzed.

Results

Of the 59 patients, 9 (15.25%) flaps exhibited partial necrosis. No significant differences were found between the survival and partial necrosis groups regarding gender, age, soft tissue defect site, length and width of the fascia pedicle, length of the skin island, length–width ratio (LWR), and pivot point (P > 0.05). However, the survival group showed significantly less width of the skin island and total length of the flap than the partial necrosis group (P < 0.05). Multiple logistic regression analysis revealed that the width of the skin island was an independent risk factor affecting partial flap necrosis (OR = 4.028; P = 0.041).

Conclusions

The PTAPF flap can be effectively used to repair small and medium wounds of the lower and middle leg, ankle and foot. As the width of the skin island exceeds 6 cm, the risk of partial flap necrosis significantly increases.

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Availability of data and materials

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Acknowledgements

Not applicable.

Funding

National Natural Science Foundation of China, Grant/Award Number: 81672188; Health and Family Planning Commission of Hunan Province, Grant/Award Number: B20180313.

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Authors

Contributions

PP and JWW designed the research and drafted the manuscript. ZGD and LHL performed the surgical treatment, participated in its design and coordination, and helped to write the manuscript. ZBL and LZ helped to collected and analyzed the patient data. All authors had read and approved the final manuscript and ensured that this is the case.

Corresponding author

Correspondence to Jianwei Wei.

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Conflict interest

The authors declare that they have no competing interests.

Ethics approval

This study was approved by the medical ethics committee of the Second Xiangya Hospital Central South University. All patients involved in this study gave informed written consent to participate.

Consent for publication

Written informed consent was obtained from all participants.

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Peng, P., Dong, Z., Wei, J. et al. Risk factors related to the partial necrosis of the posterior tibial artery perforator-plus fasciocutaneous flap. Eur J Trauma Emerg Surg (2021). https://doi.org/10.1007/s00068-021-01616-0

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Keywords

  • Posterior tibial artery
  • Perforator flap
  • Risk factors
  • Soft-tissue defect
  • Survival