An Anatomic Analysis And Clinical Study On Design The Perforator Flaps With Double Peroneal Artery

Chapter1An study on Double peroneal artery perforators flap designanalysis of the anatomyObjective Little legs and its perforators of the peroneal artery dissection analysisthrough the location, distribution, vascular pedicle length, diameter, accompanying veinand the wear there is the relationship between vascular flap area and perforators supported,study and perfect the peroneal artery perforators match between joint and its supportmechanism of the flap, explore joint double perforators peroneal artery to cut out thefeasibility and necessity of large-area skin flap, design of double perforators peronealartery flap for clinical provide morphologic basis.Methods Will fresh calf body specimens of8underwent arterial perfusion latex-lead oxide, and microdissection, isolating the peroneal artery perforators and its trunk andfeed on the flap in X-ray imaging, records of the peroneal artery perforators vascularanatomy is mainly vascular morphology, contorts, distribution, wear vascular pediclelength, vascular diameter, accompanying vein and its single found of contact with eachother and their mutual support between the area of the flap research analysis, screening fordouble perforators flap vascular pedicle.Results with spass13.0statistic software.Results8cases of crus specimen, the anatomical observation to the peroneal artery diameter of5mm or wear vascular4~5,6cases of specimens of peroneal artery diameterof5mm or wear vascular5pieces, the experimental group8lateral crus specimen,observed the lateral crus skin perforators of the peroneal artery (perforators from the deepfascia plane to superficial fascia plane distance, perforators in deep fascia plane the outerdiameter of0.5mm or higher) with a total of37.Different wear exists not only betweenvascular branch network connection, there is also a direct anastomosis connectingtraffic.Behind the wear protection attachment1.5cm flap blood supply of front and rearsymmetry.Of which the most coarse wear branch diameter2, outer diameter (0.94+0.11)mm, a longer vascular pedicle, pedicle length of blood supply (6.61+6.61) cm, flap fit asthe preferred a larger area, with other design double perforators flap perforators.Conclusions Perforators of the peroneal artery constant exists in the deep fascialayer4can be used as a free flap vascular pedicle, of which the most article2bulky,perforators and article2of article3and4in the diameter, vascular pedicle length,vascular distribution location, nutrition skin flap were superior to the rest of the wear onthe area of vascular, therefore the joint double cut in vascular flap harvest, article2wear ajoint third or fourth branch as a vascular pedicle has more advantages. Chapter2The clinical application of peroneal artery double perforatorsflap designObjective To explore application of double peroneal artery perforators flap repair footof large-area wound, and to explore the effect of double perforators flap to repair the advantages and disadvantages of the flap.Methods Clinical7cases, choose appropriate cases are consistent with vascularpedicle skin flap, choose wear vascular perforators2and3as double wear vascularpedicle, flap axis is located at1.5cm on all wear protection rear attachment, cut flapharvest, cutting area, and gradually expand the flap flap size:4cm x5cm~6cm x14cm.Results The7cases were transplanted tisssues survived is good, does not appearwithin14days after the operation, vascular crisis, flap for severe swelling, blood stasispurple of flap blood supply of the performance, wound healing.Were followed up for1~3months postoperatively, all transplanted tisssues survived, flap is soft, with thesurrounding skin color close, good color and skin flap donor site had no effect on bodyfeeling, activity, direct woo suture donor area only with linear scar, skin graft to repair theskin graft area full, not seen for area because of muscle adhesion waved scar contracturemuscle activity and a barrier.2cases of flap for line flap skiving, flap restore somefunction.Patients obtained satisfactory effect on transplanted skin flap to repair, little legsfor district activities, feel no effect.Conclusions Combined peroneal artery perforators2and3or4perforators takinglarger blood vessels as a vascular pedicle skin flap, preoperative combined with dopplerdetermine the position of wear protection, and to wear protection attachment1.5cmbehind the position as the axis of the flap, based on the defect size, shape, design of theflap of the wound.Select the area suitable for anastomosis, shape cutting area is larger,more varied and better blood supply, high survival rate of flap.