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Delayed supramalleolar flap--an innovative technique for enhanced viability
Syed Kamran Ahmed1, Pervaiz Mehmood Hashmi
1Division of Orthopaedics, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
Journal of Ayub Medical College, Abbottabad : JAMC
|December 3, 2005
Summary
Delaying lateral supramalleolar flaps for 48 hours enhances their survival and allows for larger dimensions. This two-stage procedure improves circulation, especially in flaps with vascular variations or larger sizes.
Area of Science:
- Plastic Surgery
- Microsurgery
- Vascular Surgery
Background:
- Flap delay enhances circulation by opening choke anastomotic vessels.
- Lateral supramalleolar flaps can face survival issues due to large dimensions or vascular variations.
Observation:
- Eight patients underwent a delayed lateral supramalleolar flap procedure.
- Reasons for delay included large flap dimensions (50%), absent peroneal artery perforator (37.5%), or poor initial circulation (12.5%).
Findings:
- All eight patients achieved excellent coverage with no flap failure after the delay.
- The delay procedure allowed for successful transfer of larger flaps and those with vascular anomalies.
Implications:
- Flap delay is a valuable technique to improve the viability and expand the usable dimensions of lateral supramalleolar flaps.
- This strategy effectively addresses compromised circulation in challenging flap cases, ensuring successful reconstruction of foot and ankle defects.