"Two-point and two-line method" in design of free perforator flap of medial sural artery: clinical application and clinical significance
10.3760/cma.j.cn441206-20240425-00108
- VernacularTitle:"两点两线法"在游离腓肠内侧动脉穿支皮瓣中的设计应用和临床意义
- Author:
Yan ZHANG
1
;
Yucheng LIU
;
Yang CAO
;
Haibo WU
;
Yongtao HUANG
;
Chengpeng YANG
;
Fengwen SUN
;
Qinfeng GAO
;
Jihui JU
;
Guangzhe JIN
Author Information
1. 苏州瑞华骨科医院，苏州 215104
- Publication Type:Journal Article
- Keywords:
Perforator flap of medial sural artery;
"Two-point and two-line method" for perforator location;
Repair;
Microsurgical operation
- From:
Chinese Journal of Microsurgery
2025;48(1):55-59
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the feasibility of design and harvest of free medial sural artery perforator flap with the "two-point and two-line method".Methods:From September 2022 to June 2023, Suzhou Ruihua Orthopaedic Hospital implemented the "two-point and two-line method" to guide preoperative perforator positioning and flap design. Thirty medial sural artery perforator flaps were successfully harvested with the method, and 21 wounds of hand and 9 of foot and ankle were reconstructed with the flaps. The size of soft tissue defects were 2.5 cm×2.5 cm-7.0 cm×14.5 cm, and the flaps size were 3.0 cm×3.0 cm-7.5 cm×15.0 cm. All donor sites were directly closed or by skin grafting. All patients were entered in 6-15 months of postoperative outpatient follow-up, and the recovery of donor and recipient sites was assessed by the comprehensive evaluation scales. The sensory function of the flaps was evaluated using the sensory function evaluation standard of British Medical Research Council (BMRC).Results:All perforators were successfully located with 47 perforators in total, and all of them were musculocutaneous perforator. It was found that there was 1 perforator in 14 flaps, 2 perforators in 15 flaps and 3 perforators in 1 flap. All 30 flaps survived after surgery, beside 2 flaps that had arterial insufficiency but survived successfully after surgical exploration. All donor sites healed in one stage. Comprehensive evaluation scale of flap was employed to evaluate the flaps and the scores were 84 points to 96 points with an average score of 92.5 points. The excellent and good grades were achieved in 27 flaps and 3 flaps, respectively, with a combined excellent and good rate at 100%. Sensation of the flaps was evaluated by BMRC with 1 flap of S 1, 17 of S 2 and 12 of S 3. Conclusion:The "two-point and two-line method" has been used in design of the perforator flap of medial sural artery. This method is simple and accurate, and is feasible and ideal in design of flaps before surgery.
