dorsal foot flap

The dorsal skin flap is taken from the dorsal skin of the foot and contains the dorsal artery and saphenous vein. It contains the medial cutaneous nerve of the dorsal dorsum and the medial cutaneous nerve of the dorsal dorsum. These flaps may include these vessels and nerves, as well as extensor tendons. . The projection line of the dorsal artery of the foot can be drawn by touch sensing, so as to design the flap for the central axis, the proximal end can reach the calf cruciate ligament, the distal end can reach the toe root, and the sides can reach the side midline. The blood vessels of the dorsal flap of the foot are constant and thin, and should be used for the hand, but the donor area is small, and the back of the foot needs to be repaired with the skin. This flap is forbidden when the blood supply to the posterior tibial artery is poor. Treatment of diseases: burns, chemical burns Indication 1. There is a choice of the valve area for the skin color texture of the valve area is suitable for the skin area, there are a set of arterial and venous blood vessels for kissing, and the blood vessel variation is small. 2. There is a group of blood vessels in the affected area for kissing. 3. With microsurgical technology and equipment. 4. Not suitable for skin grafts or pedicled skin grafters. 5. The patient's general condition is allowed. Preoperative preparation 1. Improve the general condition: If the patient has anemia, low plasma protein, dehydration, etc., it must be treated first. 2. The granulation wound needs to be prepared for a period of time, including unobstructed drainage, diligently changing the dressing and saline wet compress (usually wet for 2 to 3 days), proper pressure dressing, raising the affected limb, waiting for the germination color to be fresh and rosy, texture Solid edema, less secretion, no inflammation around the wound edge, can be skin grafting. If the granulation tissue is high, it is feasible to remove it. 3. Fresh wounds should be treated according to the debridement steps, so that the wounds have no active bleeding and necrotic tissue, and the edges are trimmed neatly. 4. The donor site should be shaved 1 day before surgery, brushed with soapy water, wiped dry, then rubbed with alcohol, wrapped with sterile towel, can not use strong disinfectant (such as iodine, etc.), so as not to damage the epidermis, reduce The skin is vital. Skin disinfection was performed with 1:1000 thiomersal and 75% alcohol during surgery. Surgical procedure The proximal edge of the flap was incised with a sharp-edged knife to expose the dorsal artery of the foot and the saphenous vein. A longitudinal incision was added to remove the vessel to the length required for the vascular pedicle. If necessary, the cruciate ligament was longitudinally cut. The two sides and the distal edge of the flap were incised, and the flap was separated sharply on the superficial periorbital membrane. The lateral side was to the back of the long toe of the second toe, and the medial side was to the back of the elongated tendon. The arteries and arcuate arteries cut the short tendon in the anterior medial space of the first ankle, and the broken end was sutured on the flap. Then, the first dorsal artery was exposed and ligated, and the deep branch of the plantar artery of the dorsal artery of the foot was obtained proximal to the first ankle gap, and was also ligated and cut. Then, the flap was separated from the distal and proximal sharpness of the humerus and the foot flap was not removed from the flap until the flap was completely lifted. Only the proximal vascular pedicle was continuous.