FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely the reconstructive surgery, and may be used to replace investing tissue of distal part of lower extremity at its traumatic defects exposing the subject structures. Before it the area of the defect is measured. Then form a flap on the Sural artery backflow with the inclusion of v. Parva, oriented along the axis of the flap. Flap is rotated to the site of the defect and the donor wound is covered with perforated split transplant. During the preoperative period according to the Doppler study the small subcutaneous vein and the distal septal-cutaneous perforator are labeled from the basin of the fibular artery. The musculocutaneous flap of muscle thickness not less than 0.5 cm, in the form of a tennis racket is formed, placing the pedicle of a dermal-fat component width of 2 cm, and the fascial-fat not less than 4 cm, and the flap itself strictly the along the median line of the rear surface of the tibia at the level of the calf muscle and on the lateral edge of the Achilles tendon in the distal part. The flap is formed with inclusion of the medial cutaneous nerve in the upper and the middle thirds and Sural nerve in the lower third of the lower leg and is rotated in the point positioned not less than 1 cm proximal to the distal cutaneous septal perforator.
EFFECT: method allows to reduce the treatment and improve fates by reducing the amount of Sural flap necrosis.
1 ex, 7 dwg
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Authors
Dates
2010-06-10—Published
2009-03-30—Filed