Use of Dual skin paddles Anterolateral Thigh Perforator flaps in Reconstruction of complex defect of the foot and ankle

Publication date: Available online 12 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Liming Qing, Pangfeng Wu, Fang Yu, Zhengbing Zhou, Juyu Tang
BackgroundComplex soft tissue defect around the ankle and foot still was a difficult reconstructive problem for orthopedic and plastic surgeons. This study describes our clinical experience with the application of dual skin paddles anterolateral thigh perforator (ALTP) flap for reconstruction of complex defects around the ankle and foot.Methods: From June 2010 to June 2015, we retrospectively analyzed 15 patients with complex defects in the ankle and foot. Three types of soft-tissue defects include: irregular defect (n=1), nonadjacent defect (n=4) and extensive defect (n=10). All patients in this series had exposure of underlying vital structures including vessels, nerves, bones, and tendons. All patients in this series underwent reconstruction with the dual skin paddles ALTP flap.Results: The dual skin paddles ALTP flaps were successfully harvested to reconstruct three types of soft tissue defects in the ankle and foot. All the flaps survived. Only one flap had partial flap necrosis. One case suffered minor wound-edge necrosis. All donor sites were closed directly and healed well. The mean follow-up time was 24.46 (range 12 to 54) months. The average static 2-point discrimination (s2PD) of the flap was 33 (range 27 to 38) mm. The mean visual analogue scale score for the aesthetic appearance of the reconstructed defects was 8.9 (range 8 to 9.5).ConclusionOur experience showed that the dual skin paddles ALTP flap can provide two independent skin paddles for complex defect reconstruction whilst minimizing donor site morbidity. It is a reliable option for reconstruction of complex defects in the ankle and foot.