FREE VASCULARIZED POPLITEAL ARTERY CUTANEOUS BRANCH FLAP FOR REPAIR OF WOUND ON FOOT AND ANKLE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHENLilin , SONGSuping , LINCuixia , LIWenlong ,  SUNXuesheng , ZHUTao , LIQiang

No. 2 Department of Orthopedics, Laiwu Hospital Affiliated to Taishan Medical College, Laiwu Shandong, 271100, P. R. China;

Corresponding author：

SUNXuesheng, Email: jialilve@163.com

Keywords：

Popliteal artery cutaneous branch flap; Lateral tarsal artery and vein; Wound on foot and ankle; Wound repair

DOI：

10.7507/1002-1892.20140020

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Objective To investigate the feasibility and effectiveness of free popliteal artery cutaneous branch flap anastomosed with lateral tarsal artery and vein for the repair of wound on the foot and ankle by anatomical observation and clinical application. Methods Latex was poured into the blood vessels of 8 cadavers, then perforator vessel of posterolateral upper calf was dissected, and the popliteal artery cutaneous branch flap was designed with a pedicle of 2.5 cm in length; the lateral tarsal artery of the foot was dissected, could be freed to 6 cm in length; the diameter of these vessels was measured, and the number of the accompanying veins was counted. Between March 2010 and January 2013, 13 cases of foot and ankle wounds were repaired with popliteal artery cutaneous branch flap anastomosed with lateral tarsal artery and vein. The size of flaps ranged from 6.0 cm×4.0 cm to 7.5 cm×5.5 cm. There were 11 males and 2 females, aged from 41 to 65 years (mean, 47.3 years). The causes of injury included traffic accident in 8 cases, crushing in 4 cases, and twist by machine in 1 case. The size of wounds, ranged from 5.0 cm×3.5 cm to 7.0 cm×5.0 cm. The donor sites were sutured directly. Results According to anatomical observation, the popliteal artery cutaneous branch flap was designed by using the lateral popliteal artery perforator for shaft. The vessel of the pedicle perforator flaps from the popliteal artery cutaneous branch flap matched well with the lateral tarsal artery. Clinical results: vascular crisis occurred in 2 flaps, which survived after symptomatic treatment; the other flaps survived, with primary healing of wound and incision at donor site. The patients were all followed up 5-18 months (mean, 11 months). The flap had normal color and good elasticity. Second stage operation was performed to make the flap thinner in 3 female patients because of bulky flaps. The remaining patients had no obvious fat flap. According to American Orthopaedic Foot and Ankle Society (AOFAS) score for evaluation of the ankle function at 6 months after operation, the results were excellent in 7 cases, good in 5 cases, and fair in 1 case, with an excellent and good rate of 92.3%. Conclusion Free popliteal artery cutaneous branch flap anastomosed with lateral tarsal artery and vein for the repair of wound on the foot and ankle is simple and effective. The donor site is hidden.

Citation： SHENLilin, SONGSuping, LINCuixia, LIWenlong, SUNXuesheng, ZHUTao, LIQiang. FREE VASCULARIZED POPLITEAL ARTERY CUTANEOUS BRANCH FLAP FOR REPAIR OF WOUND ON FOOT AND ANKLE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(1): 88-91. doi: 10.7507/1002-1892.20140020 Copy

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1. 赵民,李然,李大村,等.足踝部皮肤软组织缺损的修复.中国修复重建外科杂志,2012,26(2):255-256.
2. 施耘,冯世海,曲年振,等.腓肠神经营养血管蒂逆行岛状皮瓣修复足踝部深度烧伤.中国修复重建外科杂志,2006,20(4):481-482.
3. 胡勇,王增涛,朱小雷,等.带感觉神经的足背动脉蒂跗外侧动脉皮瓣修复前足缺损.中华显微外科杂志,2007,30(2):91-92.
4. 张继春,田德虎,张克亮,等.应用足跗外侧动脉逆行岛状皮瓣修复前足皮肤缺损.中华显微外科杂志,2007,30(2):128.
5. 魏勇,李钧,童哲,等.跗外侧皮瓣修复甲皮瓣术中趾供区的创面.中华手外科杂志,2010,26(5):318.
6. 杨锦,杨晓东,刘扬武,等.游离跗外侧皮瓣修复指腹皮肤软组织缺损.中华显微外科杂志,2012,35(3):222-223.
7. 苗卫华,刘振,许超.逆行跗外侧动脉皮瓣修复前足皮肤软组织缺损.中国修复重建外科杂志,2010,24(1):53-56.
8. 徐永清,朱跃良,范新宇,等.吻合血管的小腿穿支皮瓣修复四肢创面.中华显微外科杂志,2012,35(6):450-452.
9. 顾加祥,刘宏君,潘俊博,等.游离髂腹股沟皮瓣在足部创面的应用.实用手外科杂志,2012,26(3):229-230,251.
10. 侯春林,顾玉东.皮瓣外科学.上海:上海科学技术出版社,2006:663.
11. 蔡锦芳,丁自海,陈中伟.显微足外科学.济南:山东科学技术出版社,2002:533-535.
12. 王增涛,王一兵,丁自海,等.显微外科临床解剖学图谱.济南:山东科学技术出版社,2009:595-597.
13. 郑和平.显微外科解剖学实物图谱——四肢组织瓣分册.北京:人民卫生出版社,2004:113-115.
14. 于绍斌,董启榕,王亚斌.同种异体骨移植在移位关节内跟骨骨折手术中的应用.中国修复重建外科杂志,2008,27(7):869-872.
15. 孙超,王增涛,侯致典,等.骨间后动脉皮支链皮瓣的应用解剖.中华显微外科杂志,2012,35(1):46-49.

Chinese Journal of Reparative and Reconstructive Surgery

FREE VASCULARIZED POPLITEAL ARTERY CUTANEOUS BRANCH FLAP FOR REPAIR OF WOUND ON FOOT AND ANKLE

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