Palmar contracture release with arterialized venous instep flap: An anatomical and clinical study
| Autor: | Selcuk Isik, Mustafa Sengezer, Fatih Zor, Bulent Yalcin, Muhitdin Eski, Levent Tekin |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Contracture Adolescent Anastomosis Surgical Flaps Young Adult Cadaver medicine Humans Saphenous Vein Foot Injuries Vein Foot business.industry Anastomosis Surgical Suture Techniques Equinus Deformity Venous plexus Anatomy Plastic Surgery Procedures eye diseases Surgery Treatment Outcome medicine.anatomical_structure Female Deep fascia medicine.symptom Burns business Palmar Region Follow-Up Studies |
| Zdroj: | Journal of Plastic, Reconstructive & Aesthetic Surgery. 68:984-989 |
| ISSN: | 1748-6815 |
| DOI: | 10.1016/j.bjps.2015.03.024 |
| Popis: | Summary Background Plantar skin has similar histologic features to the palmar area and appears to be the ideal tissue for reconstruction of the palmar region. In this study, an anatomic examination was performed to determine the superficial venous architecture of the instep area, and the use of arterialized venous instep flaps for palmar contracture release was assessed. Methods The anatomical study was performed on 12 fresh cadaver feet. The arterialized venous instep flap, including the skin, subcutaneous tissue and superficial venous plexus, was harvested. To determine the venous structure, dissection (n = 6) and injection-corrosion (n = 6) techniques were used. In the clinical study, nine arterialized venous instep flaps were used for palmar contracture release. All flaps were harvested above the deep fascia and included skin, subcutaneous fat, and the superficial venous plexus. At the plantar site of the flap, two or three veins, one of which was used, were dissected for a sufficient length for the arterial anastomosis. The saphenous vein was used for the venous anastomosis. Results Dissection and injection-corrosion techniques revealed that the flap had 7–12 and 4–6 veins at its plantar and superior edges, respectively, with numerous anastomoses and interconnections between the veins. The flap dimensions were between 3 × 5 cm and 4 × 6 cm. All flaps survived, with two partial flap necrosis that healed with spontaneous epithelization. No debulking procedures were undertaken and all flaps adapted well to the recipient site. Conclusions The arterialized venous instep flap is a good alternative to reconstruct palmar contractures by adding similar tissue that is thin and pliable with minimal donor site morbidity. |
| Databáze: | OpenAIRE |
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