Direction And Application Of The Horn Shaped Fasciocutaneous Perforator Flaps Of Plantar

Objective: To study the distribution rules and its flowing dynamics of perforatingarteries of plantar with high-frequency color Doppler ultrasound and acoustic Doppler,To design the horn shaped fasciocutaneous perforator flaps based on the result and setup the specimen model and to discuss the flaps’ clinical effect.Methods: There were10healthy volunteers, The distribution rules and flowingdynamics of perforating arteries of their plantars were measured with high-frequencycolor Doppler ultrasound and acoustic Doppler, compared these methods. According toabove-mentioned results,3fresh cadavers were handled with the horn shapedfasciocutaneous perforator flaps on plantar, the cadavers’ plantar were dissected alongthe perforating arteries that supply the flaps. From Jan.2010to Dec.2013,10caseswith plantar defects were treated with the horn shaped perforator flaps, watched thetherapeutic effect of the flap.Results:(1) In altogether20plantars studied with the two methods, Acoustic Dopplerfound415perforating arteries, the sub-points of the perforating arteries located in thearch of the plantar. With high-frequency color Doppler ultrasound,442perforatingarteries were found, including158musculocutaneous perforating arteries and279cutaneous perforating vessels, the average initial internal diameter was0.085±0.014cm，the average vascular flow peak systolic velocity was20.89±1.2cm/s，the averagedistance was0.740±0.23cm. The perforating arteries were concentrated in the middleof plantar.(2) The models of specimen were set up, according to the searched result, theperforator arteries rooted in media plantar artery (MPA) which had lots of perforating arteries in the middle of the plantar.(3) In these ten flaps were transplanted, All theflaps survived completely with primary healing both on donor and recipient sites. Theflap color, texture, function and appearance were satisfactory during the follow-upperiod of3-24months.Conclusions: The plantar horn shaped perforator flap which was designed based on thedistribution rules of perforating arteries of plantar can reconstruct the defects at plantarweight-bearing area with the similar thick skin tissue, which facilitates the functionalreconstruction. No skin graft is necessary for the defect at donor site.