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[Clinical application of sural neurocutaneous island flaps]
Hao-Che Xia1, Yu An, Zhang-Jiang Hou
1Division of Emergency Surgery, the Ist Hospital of Harbin Medical University, Harbin 150040, China.
Objective:
To explore the clinical application characteristics of sural neurocutaneous island flaps.
Methods:
Sural neurocutaneous island flaps were used to repair the skin defect accompanied bone and tendon exposure in the lower leg, around the ankle and foot in 21 cases, including 4 cases to repair the foreside of the foot back . Direct flap was used in 5 cases and reverse flap in 16 cases. Meanwhile the coverage and formation of sural nerve were surveyed together with the starting point of peroneal perforator.
Results:
All the 21 sural flaps were survived, including sural nerve (18 cases) anastomose 12 cases, single trunk 4 cases, double trunk 2 cases. The anastomose site of medial sural cutaneous nerve and the communicating branch of lateral sural cutaneous nerve was at the point of 11 - 14 cm above the ankle in 12 cases. The lower was the anastomose site, the shorter was the sural nerve. The site is 4 - 7 cm above the ankle in 15 out of 18 sural nerve perforator branch cases, and the other 3 cases is 10, 11, 11.5 cm above the ankle respectively.
Conclusions:
Sural neurocutaneous island flaps are easy to separate. Major arteries are not injured. It is the ideal flap to repair the skin defect accompanied by bone and tendon exposure in lower leg, around ankle and foot. The nerve must be anastomosed when repairing the heel.
