Increasing the success of reverse sural flap from proximal part of posterior calf for traumatic foot and ankle reconstruction: Patient selection and surgical refinement

Microsurgery ◽  
2013 ◽  
Vol 33 (5) ◽  
pp. 342-349 ◽  
Author(s):  
Johnlong Tsai ◽  
Han Tsung Liao ◽  
Po Fang Wang ◽  
Chien Tzung Chen ◽  
Chih Hung Lin
Keyword(s):  
Patient Selection ◽  
Proximal Part ◽  
Foot And Ankle ◽  
Sural Flap

Neurotized sural flap: An alternative in sensory reconstruction of the foot and ankle defects

Microsurgery ◽  
2014 ◽  
Vol 35 (3) ◽  
pp. 183-189 ◽  
Author(s):  
Onder Tan ◽  
Osman E. Aydin ◽  
Recep Demir ◽  
Ensar Z. Barin ◽  
Hakan Cinal ◽  
...  
Keyword(s):  
Foot And Ankle ◽  
Sural Flap ◽  
Sensory Reconstruction

scholarly journals Reverse Sural Flap for Repair of Foot and Ankle Defects: Our Cases, Modifications, and a Literature Review

2020 ◽  
Vol 6 ◽  
pp. 2513826X2094798
Author(s):  
Recep Anlatici
Keyword(s):  
Literature Review ◽  
Traffic Accidents ◽  
Spinal Cord Injuries ◽  
Reverse Flow ◽  
Foot And Ankle ◽  
Sural Flap ◽  
Flap Repair ◽  
Flap Monitoring ◽  
Subcutaneous Tunnel ◽  
The Mean

Introduction: Reverse-flow sural flap is a valuable option in cases of lower extremity repair. In this study, we aimed to present our sural flap applications and modifications for the treatment of ankle and foot defects and to evaluate our results in the light of historical process and current literature. Materials and Methods: A reverse-flow fasciocutaneous flap was performed in 14 patients to repair foot and ankle defects. In 6 cases (42.86%), we chose to perform interpolation sural flaps where we aimed to repair the distal defects of the foot and/or in order to prevent patients from having trouble wearing shoes due to bulkiness of the flap pedicle at the ankle. In other cases (tunnel flap group, 57.14%), the pedicle of the flap was passed through the subcutaneous tunnel. Wide and meticulous dissection of the tunnel, nitroglycerine application on the flap, and close flap monitoring were our protective measures. Our results were analyzed statistically. The literature review was performed from Medline and PubMed. Results: Sural flap repair was performed in 14 patients. The mean age was 32.75 years. Etiologic factors were traffic accidents, spinal cord injuries, and hyperkeratotic lesions. The defects were localized in the ankle or proximal foot in 12 (85.71%) patients and the distal foot in the remaining patients (14.29%). The mean area of the defects was 46.75 cm2. Partial necrosis at the distal flap developed in 2 (25%) cases in the tunnel group and in 1 (16.67%) in the interpolation group (3 cases in total, 21.43% in the study population). No statistical difference was found between the flap groups in terms of patient distribution and complications. Conclusion: Wide dissection of the subcutaneous tunnel through which the pedicle is passed (in the tunnel group), application of nitroglycerin, meticulous hemostasis, and postoperative follow-ups are important factors for a successful reverse sural flap application. Sural interpolation modification is advantageous in several cases as the flap can reach farther and does not cause bulkiness in the ankle that would impair shoe wear. However, the disadvantage is that it requires 2 sessions.

Evaluating Patients for Elective Outpatient Foot and Ankle Surgery: Insurance as a Predictor of Patient Outcomes

2019 ◽  
Vol 12 (6) ◽  
pp. 522-529
Author(s):  
Wajeeh Bakhsh ◽  
Sean Childs ◽  
Irvin Oh ◽  
Sam Flemister ◽  
Judy Baumhauer ◽  
...  
Keyword(s):  
Patient Selection ◽  
Patient Reported Outcomes ◽  
Elective Surgery ◽  
Pain Patient ◽  
Trauma Patients ◽  
Foot And Ankle ◽  
Missed Appointments ◽  
Ankle Surgery ◽  
Patient Reported

Background. Elective surgical procedures necessitate careful patient selection. Insurance level has been associated with postoperative outcomes in trauma patients. This study evaluates the relationship insurance level has with outcomes from elective foot and ankle surgery. Methods. Retrospective chart review was performed on patients who underwent elective surgery at a single center with 1-year follow-up. Patients were classified by insurance: under-/uninsured (Medicaid, Option plans) versus fully insured. Outcomes included narcotic refills, patient-reported outcomes (PROMIS) of pain, function, and mood, and compliance with follow-up visits. Statistical analysis involved mean comparison and multivariate regression modeling, with significance P < .05. Results. Cohort groups included 220 insured and 47 under-/uninsured. Outcomes between the insured and under-/uninsured groups differed significantly in narcotic refills (0.72 vs 1.74 respectively, P < .01), missed appointments (0.13 vs 0.62, P < .01), and PROMIS results (pain 54.5 vs 60.2; function 44.3 vs 39.5; mood 44.6 vs 51.3; P < .01). The change in PROMIS scores from preoperative to 1-year postoperative were different in pain (−7.3 vs −2.5, P = .03) and function (+6.3 vs +1.3, P = .04). Regression results confirm insurance as a significant factor (coefficient 0.27, P < .01). Conclusion. These results establish that under-/uninsured patients have worse pain, patient-reported outcomes, and functional outcomes after elective foot and ankle surgery, which may inform patient selection. Levels of Evidence: Level III: Retrospective cohort study

The Distally Based Sural Flap for Foot and Ankle Reconstruction

2007 ◽  
Vol 6 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Howard Levinson ◽  
Keith E. Follmar ◽  
Alessio Baccarani ◽  
Steffen P. Baumeister ◽  
Detlev Erdmann ◽  
...  
Keyword(s):  
Foot And Ankle ◽  
Sural Flap ◽  
Distally Based ◽  
Distally Based Sural Flap

Distally Based Adipofascial Sural Flap for Foot and Ankle Reconstruction

2011 ◽  
Vol 101 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Ali Mojallal ◽  
Christo D. Shipkov ◽  
Fabienne Braye ◽  
Pierre Breton
Keyword(s):  
Donor Site ◽  
Case Series ◽  
Dorsal Side ◽  
Medial Malleolus ◽  
Foot And Ankle ◽  
Sural Flap ◽  
Post Traumatic ◽  
Distally Based ◽  
Age Range

Background: This retrospective study of a case series analyzed the results from the application of a distally based adipofascial sural flap for nonweightbearing defects of the foot and ankle. Methods: Twenty-eight patients with post-traumatic ankle and foot defects (ten women and 18 men; age range, 17–63 years) underwent surgery between November 1, 2003, and November 30, 2008. Distally based adipofascial sural flaps were used in ten open fractures, 14 soft-tissue post-traumatic defects, and four deep burns. Defects were on the dorsal side of the foot (eight cases), the lateral malleolus (four cases), the medial malleolus and inframalleolar region (four cases), the Achilles tendon region (eight cases), and the anterior surface of the ankle (four cases). Surgical procedures were performed by a single surgeon (A.M.). Results: All of the flaps healed uneventfully. There was no partial or total flap loss. All 28 patients walked normally at the time of follow-up. Three delayed healings occurred at the donor site. Conclusions: This is a homogeneous series of lower-limb reconstructions with the distally based adipofascial sural flap, which permits better analysis of the results. This flap has a constant and reliable blood supply. It can be used for the reconstruction of nonweightbearing foot and ankle regions to avoid the bulky volume of the fasciocutaneous flap in this area and to minimize the donor site scar. (J Am Podiatr Med Assoc 101(1): 41–48, 2011)

The Distally Based Superficial Sural Flap for Reconstruction of the Foot and Ankle in Pediatric Patients

2013 ◽  
Vol 29 (03) ◽  
pp. 199-204 ◽  
Author(s):  
Lifeng Liu ◽  
Yunan Liu ◽  
Lin Zou ◽  
Zongyu Li ◽  
Xuecheng Cao ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Foot And Ankle ◽  
Sural Flap ◽  
Distally Based

Distally Based Perforator Propeller Sural Flap for Foot and Ankle Reconstruction

2014 ◽  
Vol 72 (3) ◽  
pp. 340-345 ◽  
Author(s):  
Shi-Min Chang ◽  
Xin Wang ◽  
Yi-Gang Huang ◽  
Xiao-Zhong Zhu ◽  
You-Lun Tao ◽  
...  
Keyword(s):  
Foot And Ankle ◽  
Sural Flap ◽  
Distally Based

The removal and morphology of intact biofilms from implanted venous access devices

1995 ◽  
Vol 53 ◽  
pp. 1020-1021
Author(s):  
M.A. Gregory ◽  
G.P. Hadley
Keyword(s):  
Patient Selection ◽  
Surgical Oncology ◽  
Venous Access ◽  
Common Procedure ◽  
Indwelling Catheters ◽  
Careful Patient ◽  
Novel Method ◽  
The Subject ◽  
Vascular Catheters ◽  
Venous Access Devices

The insertion of implanted venous access systems for children undergoing prolonged courses of chemotherapy has become a common procedure in pediatric surgical oncology. While not permanently implanted, the devices are expected to remain functional until cure of the primary disease is assured. Despite careful patient selection and standardised insertion and access techniques, some devices fail. The most commonly encountered problems are colonisation of the device with bacteria and catheter occlusion. Both of these difficulties relate to the development of a biofilm within the port and catheter. The morphology and evolution of biofilms in indwelling vascular catheters is the subject of ongoing investigation. To date, however, such investigations have been confined to the examination of fragments of biofilm scraped or sonicated from sections of catheter. This report describes a novel method for the extraction of intact biofilms from indwelling catheters.15 children with Wilm’s tumour and who had received venous implants were studied. Catheters were removed because of infection (n=6) or electively at the end of chemotherapy.

1767: Influence of Patient Selection on Outcome in Prostate Cancer Brachytherapy: Can we Extend Indications to higher risk Patients?

2007 ◽  
Vol 177 (4S) ◽  
pp. 587-587
Author(s):  
Thierry A. Flam ◽  
Laurent Chauveinc ◽  
Nicolas Thiounn ◽  
Dominique Pontvert ◽  
Suzette Solignac ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Patient Selection ◽  
Risk Patients
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