Anatomical study and clinical application for the vascular axis fasciocutaneous flap with sural nerve preserved / 中华显微外科杂志

ABSTRACT

@#Objective To explore the feasibility, method and indications of distally-based vascular fasciocutaneons island flap with sural nerve preserved for improving the sensory absence of lateral foot after traditional surgical procedures. Methods Sixteen lower limbs of 8 cadavers, 8 fresh limbs were infuse dthe red and blue latexes via femoral artery and vein. After 48 hours, anatomical study of the sural nerves and lesser saphenons veins with their axial arteries was performed. Clinically, 12 cases of the skin defects of foot and anterior tibias were repaired by vascular fascioeutanoons island flap, in which the aural nerves were dissociated and preserved from the flaps. Results There was a respective axial artery accompanying the sural nerve and the lesser saphonous vein. The distances between axial artery and nerve and vein were uncertain, range from 1-8 mm. Furthermore, the 2 axial arteries are communicated each other. The furthest perforators of sural artery were 12-32 nun from the top of lateral ankle, the average was 22 mm. The diameters of the perforator were 1.0-1.5 mm, the average were 1.2 mm. The sural nerves of all 12 cases were preserved in surgery. The skin sensation of the innervation of sural nerve was S3+- S4 in 4 cases, and S2+ - S3 in 4 cases. The sensation of lateral ankle area was So in 2 cases, and the lateral foot area was S1 in another 2 cases. After 6-24 months (mean 14 months) follow-up, 4 cases of S2-S3 recovered to normal in 5-30 d after surgery. Conclusion There is a positive value of preserving sural nerve for the foot sensation. The repective axial arteries accompanying the sural nerve and the lesser saphenons vein are the anatomic bases of preserving nerve. Be cantion of injuring the accompanying artery while surgery.