Arterial Fasciocutaneous Vascular Territories of the Lower Leg

Whetzel, Thomas P.; Barnard, Mark A.; Stokes, Russell B.

doi:10.1097/00006534-199710000-00016

Cited by 61 publications

(33 citation statements)

References 5 publications

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“…All flaps included dominant perforator vessels defined by preoperative hand held Doppler localisation. Several authors [7,18,23] found this to be a useful technique, refining knowledge from many anatomical studies that have mapped the network of cutaneous perforating vessels [1,4,11,17,25,26]. Niranjan et al [14] routinely use the hand held Doppler to plan V-Y perforator-based flaps around a series of adjacent perforating vessels in the lower limb.…”

Section: Discussionmentioning

confidence: 99%

Perforator-based flaps in distal upper and lower extremity defects

2002

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The reconstruction of complex distal extremity defects is challenging with both cosmetic and functional considerations. This case series reviews our experience of using perforator-based flaps in 28 patients requiring reconstruction of 30 distal extremity defects. Hand held Doppler localisation of the perforators was carried out preoperatively in all cases. Flaps used were either fasciocutaneous or adipofascial and 90% of the defects were post-traumatic. Uncomplicated closure was achieved in 22 cases, with the majority of complications being minor. Complete failure was encountered in only two cases and as such was comparable with our experience of free tissue transfer. We propose consideration of perforator based flaps as an acceptable alternative to free tissue transfer in many extremity defects and find the hand held Doppler probe to be an invaluable tool in flap planning.

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Section: Discussionmentioning

confidence: 99%

Perforator-based flaps in distal upper and lower extremity defects

2002

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“…Tem como base a anastomose da arcado arterial em torno do tornozelo com ramo perfurante da artéria fibular, que emerge da membrana interóssea a aproximadamente 5 cm do maléolo lateral. Esta anastomose emite ramos para pele nesta altura e fazem anastomose com o plexo que acompanha o nervo fibular superficial, que por sua vez constitui território septocutâneo da artéria tibial anterior 6 . Não foi utilizado ultrassom Doppler para identificação no pré-operatório em nenhum dos casos.…”

Section: Técnica Cirúrgicaunclassified

Retalho supramaleolar de fluxo reverso: aplicações clínicas

Batista

2011

Rev. Bras. Cir. Plást. (Impr.)

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RESUMOAs regiões distais do membro inferior, incluindo o terço inferior da perna e os pés, são áreas muito propensas a perda de partes moles por trauma e lesões tróficas. A posição anterior da tíbia, com sua cobertura pouco espessa e vulnerável, além da grande quantidade de tendões, que não podem permanecer expostos, exigem uma cobertura cutânea rápida e, ao mesmo tempo, complexa. A situação em relação à direção do fluxo sanguíneo, a escassez de ventres musculares para retalhos e pele pouco elástica para retalhos randomizados viá-veis complicam esta situação. No passado, retalhos com transferência intermediária foram utilizados; assim como os de perna cruzada, "cross leg", ainda são, com desvantagens importantes: dependem de mais de um tempo cirúrgico, geram muito desconforto ao paciente e nem sempre são eficazes. A microcirurgia tornou-se uma opção que contribui muito para cobertura de lesões neste aspecto, porém, depende de equipe com treinamento e material especializado. As áreas doadoras são maiores, podem causar relativo déficit funcional e utilizam troncos vasculares maiores. Os retalhos fasciocutâneos de fluxo reverso podem contribuir para a cobertura de lesões pequenas e médias nesta localização, com sequelas funcionais e estéticas menores; e menor tempo cirúrgico. Constitui eficiente opção cirúrgica por sua facilidade, segurança e versatilidade. Neste estudo, temos o objetivo demonstrar o retalho supramaleolar de fluxo reverso utilizado em 4 casos, com aplicações em situações diferentes, com resultados satisfatórios de fácil execução e reprodução.Descritores: Retalhos cirúrgicos. Traumatismos da perna. Traumatismos do tornozelo. Extremidade inferior/cirurgia. ABSTRACTThe regions of the distal lower limb, including the 1/3 lower leg and foot areas are very prone to loss of soft tissue for trauma and ulcerations. The anterior position of the tibia, with its coverage slightly thick and vulnerable, besides the large amount of tendons, which can not remain exposed, requiring skin coverage quickly and simultaneously complex. The situation with respect to the direction of blood flow, lack of muscle bellies for flaps and skin flaps for inelastic randomized viable complicates this situation. In the past, with intermediate transfer flaps were used, as the leg cross, are still with major drawbacks: they rely on more than one occasion, generate a lot of discomfort to the patient and are not always effective. Microsurgery has become an option that helps a lot to cover injuries this point, however, depends on the team with training and specialized equipment. Donor areas are larger, can cause functional impairment and use on major vascular trunks. The fasciocutaneous flaps of reverse flow can contribute to the coverage of small and medium lesions in this location, with minor aesthetic damage and functional and less time for surgery. It constitutes effective surgical option for its ease, safety and versatility. In this study we demonstrate supramalleolous flap of reverse flow used in 4 cases, with applications in diffe...

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“…Anatomical studies have verified the fasciocutaneous vascular territories of the lower leg based on segmental perforators from the trunk arteries. 2 Nakajima et al demonstrated and classified fascial perforators and gave a concept of raising fasciocutaneous flaps based on them. 3 Perforator anatomy has created new options in tissue transfer and permitted precise reconstruction that was previously not possible.…”

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confidence: 99%