Anatomy and clinical application of perforator flap from distal deep branch of medial plantar artery
10.3760/cma.j.cn114453-20200217-00051
- VernacularTitle:足底内侧动脉深支远端穿支皮瓣的血管解剖和临床应用研究
- Author:
Hui LIU
1
;
Chengliang DENG
;
Jianda CHEN
;
Xiaofan ZHOU
;
Tianwen YANG
;
Hua YU
;
Caizhi HUANG
;
Zairong WEI
;
Dali WANG
Author Information
1. 遵义医科大学附属医院烧伤整形外科 563003；贵州省第二人民医院骨科整复外科，贵阳 550001
- Keywords:
Surgical flap;
Perforator flap;
Anatomy;
Clinical study;
Medial plantar artery
- From:
Chinese Journal of Plastic Surgery
2020;36(9):1005-1010
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the anatomy and therapeutic effecton skin soft tissue defect at the great toe of perforator flap from distal deep branch of medial plantar artery.Methods:The arteries of one adult foot specimens were filled with red latex and vascular anatomy was performed. Branch distribution and anastomosis of medial plantar artery and dorsal foot artery were observed. The clinical data of 12 patients with skin soft tissue defect at the great toe repaired by retrograde perforator flap from distal deepbranch of medial plantar artery from September 2016 to September 2019 in Affiliated Hospital of Zunyi Medical University was selected, and the donor sites were repaired with skin grafts. The flap survival and complications were observed.Results:Anatomy result demonstrated that deep branch of the medial plantar artery was direct continuation of the medial plantar artery. It traveled along between short toe flexor muscle and abductor hallucis muscle, and gave out several perforators. The proximal perforators passed through the abductor hallucis muscle, and anastomosed with superficial branch of medial plantar artery, anterior medial malleolus artery, and medial tarsal artery. Three perforators were issued at the proximal end of the first metatarsophalangeal joint, namely articular perforator, cutaneous perforator, and communication branch. The cutaneous perforator was main blood supply source for perforator flap from distal deep branch of medial plantar artery.A total of 12 skin flaps were harvested from 12 patients, with an area from 4.5 cm×3.0 cm to 9.0 cm×6.0 cm. Postsurgery dark purple and a few blisters occurred in three flaps, and the sutures at the pedicle were immediately removed, and the flap was coated with antibiotic ointment to keep it moist, then the flap color gradually improved after postsurgery 5 days.12 skin flaps eventually survived completely. All patients were followed up by telephone for 2-12 months. The flap color, texture and appearance were excellent. The traumatic feet walked normally.Conclusions:The perforator flap from distal deep branch of medial plantar artery has reliable blood supply for retrograde repairing small and medium skin defect at the great toe of distal the first metatarsophalangeal joint, with simple operation, less trauma, and positive postoperative effect.
