Dorsal metatarsal artery distal perforator pedicle link-pattern flaps for wound repairing in the distal feet / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility of repairing the wounds in the distal feet with dorsal metatarsal artery distal perforator pedicle link-pattern flaps.</p><p><b>METHODS</b>Since January of 2004 to April of 2009, 30 patients with distal wounds in the feet underwent surgical wound repair using by dorsal metatarsal arteries distal perforator pedicle link-pattern flaps. Seventeen patients used the 1, 2 dorsal metatarsal artery distal perforator flaps, and 13 had the 3, 4 dorsal metatarsal artery distal perforator flaps, with the flaps measuring 4 cmx4 cm to 8 cmx7cm and the flap pedicle ranged 3-6 cm in length. The donor sites were repaired with skin grafting.</p><p><b>RESULTS</b>Twenty-nine flaps survived completely and 1 flap showed partial necrosis in the distant part (2.0 cmx1.0 cm). Twenty-one patients were followed up for an average of 11 months, during which the color, texture, and contour of the flaps remained normal without ulcers in the donor sites or the flaps.</p><p><b>CONCLUSION</b>The wounds in the distal feet can be repaired by dorsal metatarsal artery distal perforator pedicle link-pattern flaps, which is a simple, applicable and safe procedure.</p>

Repairing small wounds around ankle by medial planta island flaps pedicled with anterior tibial artery perforator in front of inner malleolus / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the application of medial planta island flaps pedicled with anterior tibial artery perforator in front of inner malleolus for repairing small wounds around ankle.</p><p><b>METHODS</b>From Jan. 2005 to Jun. 2009, 10 cases with small wounds around ankle were treated with medial planta island flaps pedicled with anterior tibial artery perforator. The flap size ranged from 7.5 cm x 2.8 cm to 13.0 cm x 5.0 cm. The wounds at the donor sites were covered with skin grafts.</p><p><b>RESULTS</b>All the 10 flaps and skin grafts were survived with primary healing. The patients were followed up for 6-12 months with satisfactory cosmetic results. The 2-point discrimination was 4-6 mm when the proximal end of saphenous nerve was not injured, and it was 9-10 mm when the nerve was injured or cut off. The patients could walk with no occurrence of ulcer in flaps or donor site.</p><p><b>CONCLUSIONS</b>The medial planta island flaps pedicled with anterior tibial artery perforator can effectively repair the small wounds around ankle with reliable blood supply.</p>

Fibular artery perforator link-pattern flaps at lateral and posterior part of leg / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of fibular artery perforator link-pattern flaps at lateral and posterior part of legs.</p><p><b>METHODS</b>From January 2007 to March 2009, 12 cases of with feet and ankle wounds were treat with fibular artery perforator link-pattern flaps at lateral and posterior part of legs. The flap size ranged from 10 cm x 10 cm to 25 cm x 13 cm. The wounds at the donor sites were closed with skin grafts.</p><p><b>RESULTS</b>All the flaps survived completely. The patients were followed up for 1-12 months (median, 6 months). The color, texture and appearance of the flaps were good.</p><p><b>CONCLUSION</b>The link-pattern flap has reliable blood supply and a large area for repairing defects. The sural nerve is reserved, resulting minimal morbidity to donor site.</p>

Anatomical study and clinical applications of the posterior tibial artery intermuscular septum branches island flaps / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report an anatomical basis for the posterior tibial artery intermuscular septum branches island flaps and its clinical value.</p><p><b>METHODS</b>The origin,course, number, caliber and distribution of the posterior tibial artery intermuscular septum branches were studied in 10 adult cadavers(20 legs). 10 cases of homonymy and opposite side ankle and adjacent soft tissue defects with posterior tibial artery intermuscular septum branches island flaps, aged 20-50 years. Free skin transplantation on the donor sites.</p><p><b>RESULTS</b>The posterior tibial artery gives off 2-7 intermuscular septum branches. Its external diameter was about 0.4-1.8 mm,and the length was about 0.3-4.5 cm. The area of flaps was 7 cm x 6 cm - 20 cm x 8 cm in the group. All the flaps were survived except 1 with partial necrosis in the distant part(3 cm x 1 cm) of the flap. 7 cases were followed up two months to three years. The color, texture and appearance of the flaps were good.</p><p><b>CONCLUSIONS</b>The kind of flap has reliable blood supply, the scope of repairing was wide; avoidance of sacrificing the major artery; the flap was easy to be dissected. It was one of the ideal flaps to repair the ankle and adjacent soft tissue defects.</p>

The use of superficial cervical artery island skin flaps in the repair of the maxillofacial and cervical scar / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the method of harvesting of superficial cervical artery island skin flap, and its clinical application in the repair of the maxillofacial and cervical scars.</p><p><b>METHODS</b>The origin, course, branches and distribution of the superficial cervical artery were studied in 10 adult cadavers. The superficial cervical artery could be divided into three segments: i.e. the segment before entering the trapezius muscle, the segment in the trapezius muscle, and the segment emerging from the trapezius muscle. Fourteen patients with maxillofacial and cervical scar contracture were enrolled in the study. The postburn scars were removed, and the wounds were covered by superficial cervical artery island skin flaps. The survival of the flap after the operation and the recovery of the neck movements were observed.</p><p><b>RESULTS</b>The length of superficial cervical artery before entering the trapezius muscle was 5.1 +/- 0.4 cm, while that inside the trapezius muscle was 2.1 +/- 0.5 cm, and that after emerging from the trapezius muscle was 4.7 +/- 0.7 cm, respectively. The internal perforating branch was located 7.3 +/- 0.6 cm beside the seventh cervical vertebrae, and 3.9 +/- 0.7 cm above the spine of scapula. The flap was from 16 cm x 7 cm to 35 cm x 12 cm in size. All the flaps survived, except one with partial necrosis in the distal part (3.0 cm x 1.5 cm) of the flap. Follow-up observation for 4 months to 3 years showed satisfactory results.</p><p><b>CONCLUSION</b>Superficial cervical artery island skin flap is simple in the flap preparation, and there is no necessity to cut the pedicle, thus it is particularly suitable for the reconstruction of severe postburn maxillofacial and cervical contracture.</p>