Peroneal artery retrograde island flap in foot Opi

e707004304 · Wysłany: Czw 21:27, 31 Mar 2011

Peroneal artery retrograde island flap in the application of foot Opinion

And flap design for the same question pour out of the discussion - the main advantage of not feeding artery of lower extremity injury potential of thin skin, in particular, may repair defects of the heel area too fall off t term chronic Fort Qu Ramie ink. Fort Wong was in a variety of limonene with vascular flap and muscle flap in primary B are widely used. Because the anatomical characteristics of the peroneal artery flap, more step in the application of primary hospital. 89 years in our hospital from the beginning of the purposes of the surgery, treatment of foot skin defects, and achieved satisfactory results. Reported as follows; clinical data in this group were operated on 9 sad. Grind foot injury, with the Ministry of large skin defects, bone exposed 2 mole down. RCC injury, the lateral skin defect with the anterior tibial, posterior tibial vascular injury in 2 or sad, varicose veins with internal and external fat chronic ulcer in 4 cases. Stains on chronic hemorrhoid 1 foot down. Are male. The oldest 69 and the youngest 23 years old. Maximum area of flap 15X10 ~ m, the minimum 3X4 ~ m. Wound stitches birds were 2 weeks spasm. Flap survived totally. 1 surgical preoperative Doppler ultrasound arterial ground guillotine to be well marked. Cutaneous artery into the skin points to a well marked. Obese patients often more difficult, not easy to determine. 2 seats are used epidural drunk. First of all clean-up by the skin area and skin area under the skin defect by the shape and size in the lower leg lateral skin flap design appropriate. Specifically: clean with a clean gauze plane close to the skin area after the plane by hand, so blood printed gauze, gauze printed in the skin defects on the corresponding shape, size, and then place the gauze cut along the blood . Placed in the lower leg lateral. Flap donor site designed accordingly. Design should be appropriate to increase the range of 0.5 ~ lcm. 3 special design of the flap of skin and deep fascia cut edges, so the free fascia. To protect the skin when the arteries of free minutes column, be careful of free peroneal artery, cut the full confer artery flap. Proximal artery ligation carving. Ligation before planing with no proximal vascular clamp clip to observe the flap blood supply. That they have a good case of the loop can be ligated. Otherwise, the flap in situ joint units. Sometimes, due to surgical traction lead to vascular spasm, flap circulation somewhat less,[link widoczny dla zalogowanych], due to wait a period of time, local gauze with warm saline or lidocaine after wet dressed, is expected to ease. Cutting through the subcutaneous tunnel. After the flap channel, Zha station area in the plane by the skin surface. Static from the donor site skin graft to repair. Discussion on the surgical procedure 1: The surgical operation, arterial location is more exploration as carving, there is a certain difficulty. It was the surgical steps in the grass-roots level have more surgery important reason for the higher failure rate. We believe that as long as serious and careful operation, pay attention to eye problems, surgical success will be improved. 1.1 After skin incision surgery, beginning from the posterior margin of fascia in the foot forward for the next sharp separation. Posterior margin of separation to the carving of bone, in the long peroneal muscle between the triceps and calf carefully dissected, dragged carving artery. When I left flap halo, careful not too sweet free, can be free in the subperiosteal bone carving, and even carved artery and adjacent periosteum with cut, free coffee artery can be avoided due to the carving artery fire. 1.2 Free to the lateral malleolus 8 ~ 10 ~ m, because it started to stick carved artery, in order not to damage the main artery and its branches carved, Petey can not be too free, together with the GAO should be a nearly free with vascular fascicle , so that these two points, is the key to successful operation. 13 conventional rubber cited Luk, attention hurried to flap hematoma, on the one hand reduce the increased pressure caused by blood in the flap blood supply or venous drainage disorders {Second, it prevents the accumulation of blood lead to infection. 2 Rating: 21 of the flap with good color, thin, cut the range available. Therefore, a larger area can be used to repair skin defects. Large area of the plantar heel defect. Dorsalis pedis artery flap can not be effectively covered, the appropriate use of this flap. 2.2 does not hurt the extremity artery. In the anterior tibial or posterior tibial blood vessels injury. Can still use this flap. 2.3 The thin flap, donor site suitable repaired. Such rate is not wearing shoes rub. In the heel and the lateral skin defect, the use of this flap to prevent flap hypertrophy due to caused the discomfort, inconvenience shoes easy to accept the patient, indications wide.