The «Propeller»–technique in plastic surgery of the extensive wounds of distal leg and the foot
Objective. To increase the efficacy of plastic surgery in treatment of the extensive soft tissue defects, applying “sparing” resection of the lower third of the shin and foot for consequences of mechanical and/or thermal trauma or infectious–necrotic processes.
Materials and methods. We conducted a retrospective evaluation of the “Propeller”–technique application for the elevation of the skin islet flaps on sural neurovascular pedicle in 11 patients, who underwent surgery between 2014 and 2017. The task for investigation was to eliminate the shin and foot defects, developed due to large–scale tissue damage. The Group 1 was organized for patients with the mine–blast trauma and the coal mine occupational injuries (2 patients followed in each category). Management of purulent–necrotic wounds (Group 2) was required in cases of amputation and resection of the foot due to either osteomyelitis (3 patients followed) or frostbites (4 patients followed).
Results. All the patients had an adequate vascular supply of the affected limbs, even in 3 patients from the Group II, who had only one artery preserved. In all cases a secondary surgical debridement, necrectomy and the soft tissue defect repair were performed during the same operation.
Conclusions. Using of the tegument tissues mobilization complex “Propeller”– technique is an effective instrument for sealing of deep complex defects of different etiology, localized in distal part of the lower extremity.
2. Wu H, Sheng JG, Zhang CQ. Free Medial Plantar Flap Connection with a Posterior Tibial Artery Flap in Reconstruction of Fore-Mid Foot Skin Defect. Plast Reconstr Surg Glob Open. 2016 Nov 28;4(11):e1091. PMID: 27975013.
3. Myung Y, Yim S, Kim BK. A comparison of axial circumference between superficial circumflex iliac artery perforator flap and other workhorse flaps in dorsal foot reconstruction. J Plast Surg Hand Surg. 2017 Dec;51(6):381-386. https://doi.org/10.1080/2000656X.2017.1279621.
4. Norbeck O, Avventi E, Engstrom M, Ryden H, Skare S. Simultaneous multi-slice combined with PROPELLER. Magn Reson Med. 2018 Aug; 80 (2):496-506. https://doi.org/10.1002/mrm.27041.
5. Turan K, Tahta M, Bulut T, Akgun U, Sener M. Soft tissue reconstruction of foot and ankle defects with reverse sural fasciocutaneous flaps. Rev Bras Ortop. 2017 May 13;53(3):319-322. https://doi.org/10.1016/j.rboe.2017.05.002.
6. Cuomo R, Nisi G, Grimaldi L, Brandi C, D'Aniello C. Use of ultraportable vacuum therapy systems in the treatment of venous leg ulcer. Acta Biomed. 2017 Oct 23;88(3):297-301. https://doi.org/10.23750/abm.v88i3.5737.
This work is licensed under a Creative Commons Attribution 4.0 International License.