49 0

Reconstruction of severe atherosclerotic and obstructive diabetic feet using thoracodorsal artery perforator flaps with long vascular pedicles.

Title
Reconstruction of severe atherosclerotic and obstructive diabetic feet using thoracodorsal artery perforator flaps with long vascular pedicles.
Author
성일훈
Keywords
FREE-TISSUE TRANSFER; ANTEROLATERAL THIGH FLAP; FEMORAL CIRCUMFLEX ARTERY; LATISSIMUS-DORSI; LOWER-EXTREMITY; LIMB SALVAGE; MICROSURGICAL RECONSTRUCTION; ARTERIOVENOUS LOOP; 10-YEAR EXPERIENCE; FOOT ULCERS
Issue Date
2018-03
Publisher
WILEY
Citation
MICROSURGERY, v. 38, no. 3, page. 287-294
Abstract
BackgroundFoot ulcers in diabetic patients often require free flaps. A long vascular pedicle is mandatory so that more proximal vessels can be used as recipient vessels, especially when the flap is used to reconstruct distal foot defects. We evaluated the outcome of diabetic foot defect that were reconstructed using thoracodorsal artery perforator (TDAP) flaps with long vascular pedicles.Patients and MethodsWe reconstructed the foot defects of 22 diabetic patients. Nineteen patients were male, and the mean age was 56.4 years. The defects were located in big toe in 11 patients; fourth and/or fifth toe, including lateral aspect of the foot, in 8 patients; and dorsum of the foot, medial plantar, and first metatarsal medial head in 1 patient each. CT angiography showed that the two main vessels of the lower leg remained intact in 7 patients, only one vessel was intact in the lower leg of 11, and no vessels were visible in 4.ResultsThe flap size ranged between 5 x 4 cm(2) and 18 x 11cm(2), with a mean pedicle length of 16.5 cm. The anterior tibial artery was used as the recipient vessel in 15 patients, while the posterior tibial artery was used in 7. All the flaps survived. Three wound disruptions and two partial flap losses healed conservatively, without further surgery. Ulcer due to diabetes recurred in three cases. The mean follow-up period was 46.1 months. All wounds healed completely.ConclusionsTDAP flaps with long vascular pedicles may be a viable choice for reconstructing defects in the feet of diabetic patients.
URI
https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.30251https://repository.hanyang.ac.kr/handle/20.500.11754/118014
ISSN
0738-1085; 1098-2752
DOI
10.1002/micr.30251
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE