Post Traumatic Skin Defect in Leg and Foot Clinical Trial
Official title:
Use of Perforator Flaps for Leg and Foot Reconstruction
Perforator vessels are those where the source artery is deep and the branch that carries
blood to the fasciocutaneous tissues passes through the overlying deep fascia.
Soft tissue defects in the lower extremity, especially distal third of leg, present a
challenge to reconstructive surgeons due to lack of reliable local flaps, conventional
reconstructive options include split skin grafting, local random fasciocutaneous flaps, cross
leg fasciocutaneous flap, pedicled muscular or musculocutaneous flaps or microvascular free
tissue transfer. All these procedures have their limitations and associated morbidity at
donor site
Taylor and Palmer defined an angiosome as a three-dimensional vascular territory supplied by
a source artery and vein through branches for all tissue layers between the skin and the
bone, and showed that between neighboring angiosomes there are choked and true anastomotic
arteries.
Koshima and Soeda in 1989, described an inferior epigastric artery skin flap without the
rectus abdominis muscle for reconstruction of floor of mouth, began the era of perforator
flaps.
The big popularity gained by the local perforator flaps was due to their main advantages: 1)
Sparing of the source artery and underlying muscle and fascia, 2) Combining the very good
blood supply of a musculocutaneous flap with the reduced donor-site morbidity of a skin flap,
3) Replacing like with like, 4) Limiting the donor-site to the same area, 5) Possibility of
completely or partially primarily closure, 6) Technically less demanding, because they are
microsurgical procedures, but without microvascular sutures, 7) Shorter operating time.
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