Volume 22 Issue 11
Nov.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(11): 1846-1849
QIU Haisheng, NI Xiao, YU Fangzheng, ZHANG Lei. Application of end-to-side arterial anastomosis in transplantations of medial sural artery perforator flap[J]. Chinese Journal of General Practice, 2024, 22(11): 1846-1849. doi: 10.16766/j.cnki.issn.1674-4152.003747
Citation: QIU Haisheng, NI Xiao, YU Fangzheng, ZHANG Lei. Application of end-to-side arterial anastomosis in transplantations of medial sural artery perforator flap[J]. Chinese Journal of General Practice, 2024, 22(11): 1846-1849. doi: 10.16766/j.cnki.issn.1674-4152.003747
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Application of end-to-side arterial anastomosis in transplantations of medial sural artery perforator flap

doi: 10.16766/j.cnki.issn.1674-4152.003747
  • 1.

    Department of Hand Surgery, Peripheral Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

Funds:

 LBY21H060001

  • Received Date: 2024-01-16
    Available Online: 2024-12-31
    Abstract
  •   Objective  To explore the clinical efficacy of free medial sural artery perforator flap transplantation for repairing soft tissue defects in the hands and feet.  Methods  In the Department of Hand Surgery at the First Affiliated Hospital of Wenzhou Medical University from March 2015 to July 2023, we used free medial sural artery perforator flaps to repair hand and foot wounds in 16 cases. All patients had either damaged or overly thick main blood vessels in the recipient area that were incompatible with the medial sural artery. The flap sizes ranged from (3.0 cm × 5.0 cm) to (12.0 cm × 7.0 cm). The donor sites were directly sutured. The arteries are anastomosed end-to-end between the gastrocnemius artery and the main blood vessels of the recipient area. For foot wounds, the flap donor site was from the ipsilateral leg, whereas for hand wounds, the flap donor site could be from either the ipsilateral or contralateral leg.  Results  All 16 flap arteries were successfully anastomosed, and the flaps survived smoothly without vascular crises. During follow-up, which ranged from 2 months to 3 years (average of 1 year), the flaps showed no significant shrinkage and they maintained good shape. The skin flap had similar color and texture to the recipient area, with a good blood supply and normal sensation. All 16 donor areas were directly sutured and healed well, with only linear scars. At the final follow-up, hand function was rated as excellent in 9 cases and good in 3 cases, while all 4 cases of toot wounds were rated excellent. All 16 patients were satisfied with the appearance of both the donor and recipient skin flaps.  Conclusion  The free medial sural artery perforator flap does not damage to the main blood vessels of the donor area and is relatively concealed. Small to medium-sized flaps can be directly sutured, minimizing donor area damage. The use of end-to-end anastomosis with the free anterolateral thigh perforator flap eliminates the need to match recipient vessels, reduces damage to the recipient ' s main vessels, thereby increasing flap survival. This procedure is an effective method for clinical repair of hand and foot wounds.

     

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