PMC5779737_01
Characteristics of wounds of the posterior talocrural region. After surgical debridement, partial Achilles tendon exposure and malleolus bone exposure accompanied by osteomyelitis were observed. The total wound size was approximately 3.4 x 7.8 cm.
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F1
The wound size was about 3.4 x 7.8 cm (Fig. 1).
Harvesting of the superficial temporal fascia flap. (A) Designing a longitudinal incision about 2 cm in the anterosuperior part of the antilobium (the region of surface projection of superficial temporal artery); if the blood vessels were in good condition, a longer incision through the temporal area to the top region was made; designing the "T"-shaped incision based on the size of the recipient area. (B) Designing and separating the fascia flap according to the size of the wound. (C) Harvesting the fascia flap. (D) Suturing the incision at the donor site.
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F2
Then, we designed and obtained the superficial temporal fascia flap according to the wound size and sutured the incision at the donor site (Fig. 2).
Superficial temporal fascia flap transplantation and skin grafting. (A) After transferring and fixing the fascia flap to the recipient site, we performed the end-to-end anastomosis of the superficial temporal vein and posterior tibial vein, as well as the end-to-side anastomosis of the superficial temporal artery and posterior tibial artery. (B) Grafting of thin split-skin.
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F3
After that, we performed the vascular anastomosis, free flap transplantation, and thin split-skin grafting at the recipient site (Fig. 3).
Treatment outcome and follow-up. (A) The fascia flap and grafted skin survived well at 1 week after operation. (B) At the 6-month follow-up, the grafted skin at the recipient site was even and without dysfunction. (C and D) Images taken at the 12-month postoperative follow-up.
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F4
A). At the 6- and 12-month follow-ups, the skin at the operated area was even, and the functional recovery was satisfactory (Fig. 4B).