title: [Analysis of the vacuum sealing drainage technique combined with sural neurovascular pedicle fascio-cutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons].
abstract: OBJECTIVE
  To evaluate the practical method of vacuum sealing drainage (VSD) technique combined with sural neurovascular pedicle fasciocutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons.
  
  
  METHODS
  From January 2006 to January 2009, 79 patients with deep wounds in the foot near the ankle joint with exposed bone and tendons were treated by VSD technique combined with sural neurovascular pedicle fasciocutaneous flap including 58 males and 21 females with an average age of 34 years old ranging from 7 to 59 years. There were 17 cases in low 1/3 part of leg and achilles tendon, 28 in lateral malleolus and lateral dorsum of foot, 21 in medial malleolus and medial dorsum of foot, 13 in heel and pelma. Firstly the wounds were debrided and cultivated by using VSD technique, then the soft tissue defections were repaired with sural neurovascular pedicle fasciocutaneous flap.
  
  
  RESULTS
  The area of flap was from 6 cm x 5 cm to 18 cm x 15 cm; All patients stayed in hospital for 14 to 30 days, 18 days in average. Living flaps of all patients were followed-up from 6 months to 3 years, the flaps of 2 patients were mostly necrotic, 3 were necrotic, 5 cases appeared obstacle of venous back streaming. The others survived with no infections.
  
  
  CONCLUSIONS
  The wound would become fresh and clean as soon as possible with VSD. The sural neurovascular pedicle fasciocutaneous flap could provide a good covering for the exposed wound. Therefore the wound healed faster with friction resistance and fine appearance. The time of hospitalization were greatly shortened after combined application.
authors.affiliation: The Third People's Hospital of Jinan, Jinan 250101, Shandong, China. jnsylhs2008@163.com
authors.forename: Hua-shui
authors.initials: HS
authors.lastname: Liu
authors.forename: Wan-zhong
authors.initials: WZ
authors.lastname: Chu
authors.forename: Tao
authors.initials: T
authors.lastname: Luan
authors.forename: Xin-min
authors.initials: XM
authors.lastname: Xie
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Jin-peng
authors.initials: JP
authors.lastname: Bu
authors.forename: Lai-Feng
authors.initials: LF
authors.lastname: Li
authors.forename: Xue-chun
authors.initials: XC
authors.lastname: Zhao
authors.forename: Xiao-meng
authors.initials: XM
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000601:surgery*; D002648:Child; D004322:Drainage / Q000379:methods*; D005260:Female; D018409:Foot Injuries / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D014618:Vacuum