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Reconstruction of lateral ankle defects with the distally-based peroneus brevis muscle flap

Year 2021, Volume: 8 Issue: 2, 227 - 231, 30.06.2021
https://doi.org/10.34087/cbusbed.783236

Abstract

Objective:Local tissue options are limited in reconstruction of lateral ankle defects. Distally-based peroneus brevis muscle flap is one of the rare locoregional options used in reconstruction of lateral malleolar defects. In this research article, our experiences with distally based peroneus brevis muscle flap in high-risk patients were presented.
Material and Methods: Patients whose defects were reconstructed with a distally-based peroneus brevis muscle flap in the lateral malleolar region between 2018 and 2020 were retrospectively screened and 5 patients were included in the study.
Results:The mean age of the patients was 65.8 (50-77). The average size of the defects was 19.6 cm2. No total flap loss were observed in the patients. Partial skin graft loss was observed in in 2 patients that secondary recovery was achieved with conventional wound dressing without additional surgical intervention. No wound dehiscence, discharge or recurrence was observed in the areas where repair was performed during an average of 1.5 years of follow-up.
Conclusion: Distally-based peroneus brevis muscle flap is a locoregional flap to cover lateral malleolar region defects that can be used safely in patients with high comorbidities.

References

  • Eren S, Ghofrani A, Reifenrath M. The distally pedicled peroneus brevis muscle flap: A new flap for the lower leg. Plast Reconstr Surg 2001;107:1443–1448
  • Jeng SF, Wei FC. Distally based sural island flap for foot and ankle reconstruction. Plast Reconstr Surg. 1997;99(3):744-750.
  • Tosun Z, Ozkan A, Karaçor Z, Savaci N. Delaying the reverse sural 6. flap provides predictable results for complicated wounds in dia¬betic foot. Ann Plast Surg. 2005;55:169-73.
  • Karamese M, Yıldıran GU, Akdağ O, Selimoglu NM, Abacı M, Tosun Z. An Alternative to Free Flap for Ankle and Heel Defects: Delayed-Reverse Flow Sural Island Flap. Turk Plast Surg 2015;23(1)
  • Mardini S, Salgado CJ, Chen HC, Yazar S, Ozkan O, Sassu P. Posterior tibial artery flap in poliomyelitis patients with lower extremity paralysis. Plast Reconstr Surg. 2006;117(2):640-645. doi:10.1097/01.prs.0000197208.29709.83
  • Cho EH, Shammas RL, Carney MJ, et al. Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis. Plast Reconstr Surg. 2018;141(1):19.
  • El-Sabbagh AH. Non-microsurgical skin flaps for reconstruction of difficult wounds in distal leg and foot. Chin J Traumatol. 2018;21(4):197-205.
  • Brunetti B, Barone M, Tenna S, Salzillo R, Segreto F, Persichetti P. Pedicled perforator-based flaps: Risk factor analysis, outcomes evaluation and decisional algorithm based on 130 consecutive reconstructions. Microsurgery. 2020;40(5):545-552.
  • Hughes LA, Mahoney JL. Anatomic basis of local muscle flaps in the distal third of the leg. Plast Reconstr Surg 1993;92(06): 1144–1154.
  • Lyle WG, Colborn GL. The peroneus brevis muscle flap for lower leg defects. Ann Plast Surg 2000;44(02):158–162.
  • Ensat F, Weitgasser L, Hladik M, et al. Redefining the vascular anatomy of the peroneus brevis muscle flap. Microsurgery. 2015;35:39–44.
  • Y.L. Chen, B.G. Zheng, J.M. Zhu, et al.Microsurgical anatomy of the lateral skin flap of the leg Ann Plast Surg, 15 (1985), pp. 313-318.
  • Graziani L, Silvestro A, Bertone V, et al. Vascular involvement in diabetic subjects with ischemic foot ulcer: a new morphologic categorization of disease severity. Eur J Vasc Endovasc Surg. 2007;33(4):453-460.
  • Barbera F, Lorenzetti F, Marsili R, et al. MRI anatomical preoperative evaluation of distally based peroneus brevis muscle flap in reconstructive surgery of the lower limb. J Plast Reconstr Aesthet Surg. 2017;70(11):1563-1570.
  • Gosau M, Schoeneich M, Koyama K, Jung EM, Fanghänel J, Prantl L. Ultrasound analyses, anatomical considerations, and clinical experience with the peroneus brevis muscle flap. Ann Anat. 2013;195(2):183-188
  • Schmidt AB, Giessler GA. The muscular and the new osteomuscular composite peroneus brevis flap: experiences from 109 cases. Plast Reconstr Surg. 2010;126(3):924-932.
  • Ensat F, Hladik M, Larcher L, Mattiassich G, Wechselberger G. The distally based peroneus brevis muscle flap-clinical series and review of the literature. Microsurgery. 2014;34(3):203-208.
  • Erne H, Schmauss D, Schmauss V, Ehrl D. Postoperative negative pressure therapy significantly reduces flap complications in distally based peroneus brevis flaps: Experiences from 74 cases. Injury. 2016;47(6):1288-1292.

Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması

Year 2021, Volume: 8 Issue: 2, 227 - 231, 30.06.2021
https://doi.org/10.34087/cbusbed.783236

Abstract

Giriş ve Amaç: Ayak bileği laterali defektlerinin onarımında lokal doku seçenekleri oldukça kısıtlıdır. Distal bazlı peroneus brevis kas flebi lateral malleol bölgesinin onarımında kullanılan nadir lokorejyonel seçeneklerden biridir. Bu araştırma makalesinde, yüksek riskli hasta grubunda distal akımlı peroneus brevis kas flebiyle onarım tecrübelerimiz aktarılmıştır.
Gereç ve Yöntemler: 2018 ve 2020 yılları arasında Başkent Üniversitesi Plastik, Rekonstrüktif ve Estetik Cerrahi Anabilim Dalı’nda, lateral malleolar bölgedeki defetleri distal bazlı peroneus brevis kas flebi ile rekonstrükte edilmiş hastalar retrospektif olarak tarandı ve 5 hasta çalışmaya dahil edildi.
Bulgular: Hastaların ortalama yaşı 65.8 (50-77) idi. Defektlerin ortalama boyutu 19.6 cm2 idi. Fleplerde kayıp yaşanmadı. 2 hastada kas üzerine konulan deri greftinde kısmi kayıp görüldü , ek cerrahi müdahale olmadan konvansiyonel pansumanla sekonder iyileşme sağlandı. Ortalama 1.5 senelik takip döneminde onarım yapılan alanlarda yara ayrılması, akıntı, nüks görülmedi.
Sonuç: Distal bazlı peroneus brevis kas flebi, lateral malleolar bölge defektlerinin kapatılması için yüksek komorbidetesi olan hasta gruplarında bile güvenle kullanılacak bir lokorejyonel fleptir.

References

  • Eren S, Ghofrani A, Reifenrath M. The distally pedicled peroneus brevis muscle flap: A new flap for the lower leg. Plast Reconstr Surg 2001;107:1443–1448
  • Jeng SF, Wei FC. Distally based sural island flap for foot and ankle reconstruction. Plast Reconstr Surg. 1997;99(3):744-750.
  • Tosun Z, Ozkan A, Karaçor Z, Savaci N. Delaying the reverse sural 6. flap provides predictable results for complicated wounds in dia¬betic foot. Ann Plast Surg. 2005;55:169-73.
  • Karamese M, Yıldıran GU, Akdağ O, Selimoglu NM, Abacı M, Tosun Z. An Alternative to Free Flap for Ankle and Heel Defects: Delayed-Reverse Flow Sural Island Flap. Turk Plast Surg 2015;23(1)
  • Mardini S, Salgado CJ, Chen HC, Yazar S, Ozkan O, Sassu P. Posterior tibial artery flap in poliomyelitis patients with lower extremity paralysis. Plast Reconstr Surg. 2006;117(2):640-645. doi:10.1097/01.prs.0000197208.29709.83
  • Cho EH, Shammas RL, Carney MJ, et al. Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis. Plast Reconstr Surg. 2018;141(1):19.
  • El-Sabbagh AH. Non-microsurgical skin flaps for reconstruction of difficult wounds in distal leg and foot. Chin J Traumatol. 2018;21(4):197-205.
  • Brunetti B, Barone M, Tenna S, Salzillo R, Segreto F, Persichetti P. Pedicled perforator-based flaps: Risk factor analysis, outcomes evaluation and decisional algorithm based on 130 consecutive reconstructions. Microsurgery. 2020;40(5):545-552.
  • Hughes LA, Mahoney JL. Anatomic basis of local muscle flaps in the distal third of the leg. Plast Reconstr Surg 1993;92(06): 1144–1154.
  • Lyle WG, Colborn GL. The peroneus brevis muscle flap for lower leg defects. Ann Plast Surg 2000;44(02):158–162.
  • Ensat F, Weitgasser L, Hladik M, et al. Redefining the vascular anatomy of the peroneus brevis muscle flap. Microsurgery. 2015;35:39–44.
  • Y.L. Chen, B.G. Zheng, J.M. Zhu, et al.Microsurgical anatomy of the lateral skin flap of the leg Ann Plast Surg, 15 (1985), pp. 313-318.
  • Graziani L, Silvestro A, Bertone V, et al. Vascular involvement in diabetic subjects with ischemic foot ulcer: a new morphologic categorization of disease severity. Eur J Vasc Endovasc Surg. 2007;33(4):453-460.
  • Barbera F, Lorenzetti F, Marsili R, et al. MRI anatomical preoperative evaluation of distally based peroneus brevis muscle flap in reconstructive surgery of the lower limb. J Plast Reconstr Aesthet Surg. 2017;70(11):1563-1570.
  • Gosau M, Schoeneich M, Koyama K, Jung EM, Fanghänel J, Prantl L. Ultrasound analyses, anatomical considerations, and clinical experience with the peroneus brevis muscle flap. Ann Anat. 2013;195(2):183-188
  • Schmidt AB, Giessler GA. The muscular and the new osteomuscular composite peroneus brevis flap: experiences from 109 cases. Plast Reconstr Surg. 2010;126(3):924-932.
  • Ensat F, Hladik M, Larcher L, Mattiassich G, Wechselberger G. The distally based peroneus brevis muscle flap-clinical series and review of the literature. Microsurgery. 2014;34(3):203-208.
  • Erne H, Schmauss D, Schmauss V, Ehrl D. Postoperative negative pressure therapy significantly reduces flap complications in distally based peroneus brevis flaps: Experiences from 74 cases. Injury. 2016;47(6):1288-1292.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section Araştırma Makalesi
Authors

Burak Özkan 0000-0003-3093-8369

Abbas Albayati This is me 0000-0003-2806-3006

Çağrı Uysal This is me 0000-0001-6236-0050

Nilgün Ertaş This is me 0000-0002-6944-1512

Publication Date June 30, 2021
Published in Issue Year 2021 Volume: 8 Issue: 2

Cite

APA Özkan, B., Albayati, A., Uysal, Ç., Ertaş, N. (2021). Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 8(2), 227-231. https://doi.org/10.34087/cbusbed.783236
AMA Özkan B, Albayati A, Uysal Ç, Ertaş N. Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. June 2021;8(2):227-231. doi:10.34087/cbusbed.783236
Chicago Özkan, Burak, Abbas Albayati, Çağrı Uysal, and Nilgün Ertaş. “Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi Ile Onarılması”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8, no. 2 (June 2021): 227-31. https://doi.org/10.34087/cbusbed.783236.
EndNote Özkan B, Albayati A, Uysal Ç, Ertaş N (June 1, 2021) Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8 2 227–231.
IEEE B. Özkan, A. Albayati, Ç. Uysal, and N. Ertaş, “Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması”, CBU-SBED: Celal Bayar University-Health Sciences Institute Journal, vol. 8, no. 2, pp. 227–231, 2021, doi: 10.34087/cbusbed.783236.
ISNAD Özkan, Burak et al. “Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi Ile Onarılması”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8/2 (June 2021), 227-231. https://doi.org/10.34087/cbusbed.783236.
JAMA Özkan B, Albayati A, Uysal Ç, Ertaş N. Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2021;8:227–231.
MLA Özkan, Burak et al. “Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi Ile Onarılması”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, vol. 8, no. 2, 2021, pp. 227-31, doi:10.34087/cbusbed.783236.
Vancouver Özkan B, Albayati A, Uysal Ç, Ertaş N. Ayak Bileği Laterali Defektlerinin Distal Bazlı Peroneus Brevis Kas Flebi ile Onarılması. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2021;8(2):227-31.