Repair of lower leg injuries with fascio-cutaneous flaps

Barclay, T.L.; Cardoso, Éder Kröeff; Sharpe, David T.; Crockett, David J.

doi:10.1016/0007-1226(82)90148-5

Cited by 97 publications

(34 citation statements)

References 1 publication

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“…Many authors, however, have found the simplicity and reliability of distally based adipofascial and fasciocutaneous flaps make these a valuable alternative to microsurgical free tissue transfer [2,22,26]. We believe our results confirm this view.…”

Section: Discussionsupporting

confidence: 91%

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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: Discussionsupporting

confidence: 91%

“…There is no prescribed size although Pontén described safely designing flaps of 18×8 cm in the lower limb. Others state length to width ratios of 3:1 [2] or 4:1 [22] as being acceptable. We did not set a specific size or length to width ratio to adhere to.…”

Section: Discussionmentioning

confidence: 97%

Perforator-based flaps in distal upper and lower extremity defects

2002

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“…Fascia is recognized as delimiting the surgical plane of the leg (Haertsch, 1981a) and is described as the site of vascularization of the fasciocutaneous flap (Ponten, 1981;Haertsch, 1981b, Barclay et al, 1982.…”

Section: Introductionmentioning

confidence: 99%

Blood supply of subcutaneous tissue in the leg and its clinical application

et al. 1995

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The vascular anatomy of the subcutaneous or adipose layer of the leg is described. The major arteries of the distal thigh and leg were injected with either a colored latex or an India ink and gelatin mixture to demonstrate the principal sources of blood supply to the skin and the superficial tissues of the leg. Microdissection and the technique of Spalteholz for dehydrating and clearing the tissues (rendering them transparent) facilitated the study of the direct and indirect arterial branches which form the three principal networks: the deep fascia, the subcutaneous or adipose layer, and the skin or the dermoepidermic layer. The results are of practical importance since the fascio-subcutaneous tissue layer can be used as a flap for covering soft tissue defects of the leg.

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“…2 Barclay et al actually attributed the success to the rich vascular network associated with the deep fascia. 3 Thereafter, various studies were directed to prove the importance of this vascular network through different parameters (e.g., microangiography in old cadavers, perioperative fluorescein study, dye studies in fresh cadavers, perioperative angiography). Most of these studies were carried out for fasciocutaneous flaps.…”

mentioning

confidence: 99%

Live Demonstration of Microcirculation in the Deep Fascia and Its Implication

Bhattacharya

Watts²,

Reddy³

2005

Plastic and Reconstructive Surgery

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The rich vascular network in the deep fascia has been emphasized by various scientists, but the actual demonstration of live circulation in the deep fascia has not previously been witnessed. Encouraged by the sight of live circulation in the web membrane of toad hind limb, a successful attempt was made to demonstrate the live circulation in the vascular network of the deep fascia. Fascial extensions of inferiorly based fasciocutaneous flaps were dissected in five patients with distal leg and heel defects. The fascial extension in continuity with a proximal retrograde fasciocutaneous flap was mounted on a glass slide and examined under a microscope. The authors witnessed the live microcirculation and the movement of individual red blood corpuscles in vascular channels of the deep fascia. The authors also noticed that the deep fascia has two layers with circulations that are independent of one other. A video recording was made to document these important features.

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Repair of lower leg injuries with fascio-cutaneous flaps

Cited by 97 publications

References 1 publication

Perforator-based flaps in distal upper and lower extremity defects

Perforator-based flaps in distal upper and lower extremity defects

Blood supply of subcutaneous tissue in the leg and its clinical application

Live Demonstration of Microcirculation in the Deep Fascia and Its Implication

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