Peroneal Arter Perforatör Flebi ile Krus Defektlerinin Rekonstrüksiyonu

Amaç
Çeþitli nedenlerle oluþabilen alt ekstremite yumuþak doku defektlerinin rekonstrüksiyonu zordur. Alt ekstremite rekonstrüksiyonunda farklý yöntemler tanýmlanmýþ olsa da peroneal arter perforatör flebi benzersiz avantajlara sahiptir. Bu çalýþmanýn amacý, gün geçtikçe popülaritesi artan peroneal arter perforatör flebinin krus defektlerinin tedavisinde kullanýmýný sunmaktýr.
Yöntem
Orta veya distal krus defekti olan ve peroneal arter perforatör flepleri ile rekonstrükte edilen 12 hasta çalýþmaya dahil edildi. Hastalar yaþ, cinsiyet, etiyoloji, komplikasyonlar, defekt alaný, defekt ve flep boyutu açýsýndan deðerlendirildi. Etiyolojik olarak bir hastada kronik yara, altý hastada travma ve beþ hastada tümör saptandý. Tümör tanýsý olan hastalarýn ikisinde skuamöz hücreli karsinom, ikisinde malign melanom ve birinde dermatofibrosarkoma protuberans vardý.
Bulgular
Hastalarýn yaþ ortalamasý 45,9’du. Hastalarýn dördü kadýn, sekizi erkekti. Defektlerin dokuzu krusun orta üçte birlik kýsmýnda, üçü ise distalindeydi. Fleplerin büyüklüðü 78 - 210 cm² arasýnda deðiþiyordu. Ýki flepte venöz yetmezlik gözlendi ve birinde flebin distalinde kýsmi nekroz geliþti. Tüm fleplerin dolaþýmý salimdi.
Sonuç
Peroneal arter perforatör flebi, krusun orta ve distal kýsýmlarýnda kullanýlabilen çok yönlü bir seçenektir.

Reconstruction of Middle and Distal Third Crus Defects with Peroneal Artery Perforator Flap

Objective
Reconstruction of lower extremity soft tissue defects, which may occur due to various reasons, is challenging. Although different methods have been described in lower extremity reconstruction, the peroneal artery perforator flap has unique advantages. This study aims to present the use of the peroneal artery perforator flap, which is gaining popularity day by day, to treat crus defects.
Methods
12 patients with middle or distal third crus defects were included in the study, who had reconstruction with peroneal artery perforator flaps. The patients were evaluated on age, gender, etiology, complications, defect area, defect, and flap size. The etiology included chronic wounds in one patient, trauma in six, and tumors in five. Two of the patients with a diagnosis of tumor had squamous cell carcinoma, two had malignant melanoma and one had dermatofibrosarcoma protuberans.
Results
The average age of the patients was 45.9 years. Four of the patients were female, and eight were male. Nine of the defects were located in the middle third of the crus, and three were distal. The flaps ranged in size from 78 to 210 cm². Venous insufficiency was observed in two flaps, and partial necrosis developed in one of them distal to the flap. All flaps survived.
Conclusion
The peroneal artery perforator flap is a versatile option that can be used in the middle and distal parts of the crus.