(DLS-039) Application of sural neurotrophic flap with perforating branch of peroneal artery in the repair of diabetic foot wounds

Lei Gao, Doctor; Tianbo Li, Doctor

Introduction: The research is to explore the clinical application of sural neurotrophic flap with perforating branch of peroneal artery in the repair of diabetic foot wounds.

Methods: The clinical data of 25 patients with diabetic foot underwent sural neurotrophic flap with perforating branch of peroneal artery (observation group) from October 2017 to June 2019 were retrospectively analyzed. Compared with 25 patients with diabetic foot repaired by vacuum sealing drainage combined with skin grafting in the same period (control group), the number of postoperative wound infection, wound healing time and recurrence rate during 1-year follow-up period were compared between 2 groups.

Results: In the observation group, vascular crisis occurred in 1 patient and flap necrosis occurred after failed rescue. The wounds healed after surgical debridement and dressing change again. In the control group, the skin graft necrosis occurred in 4 patients, and the wounds healed after surgical debridement and dressing change again. No vascular crisis and cyanoderma caused by venous return disturbance of flap were found in the remaining patients. Finally, all wounds healed in both groups. The healing time in the observation group was (15.72±2.62) d, which was significantly shorter than that in the control group of (22.08±3.21) d, the difference was statistically significant between 2 groups (t＝-7.67, P< 0.05). All patients were followed up for 6 to 12 months. During the follow-up period, 3 patients (12%) in the observation group and 8 patients (32%) in the control group were re-admitted to hospital because of diabetic foot ulcer recurrence. The recurrence rate of wounds in the observation group was significantly lower than that in the control group, the difference was statistically significant (P< 0.05).

Discussion: Compared with vacuum sealing drainage combined with skin grafting, the sural neurotrophic flap with perforating branch of peroneal artery in the repair of wounds could shorten the healing time and reduce the recurrence rate.