METHOD FOR INTRAOPERATIVE DETERMINATION OF THE DESIGN OF THE DERMAL-FAT AREA OF THE FREE PERONEAL FLAP Russian patent published in 2023 - IPC A61B17/00 

FIELD: surgery; oncology.

SUBSTANCE: invention can be used in various areas of reconstructive surgery in the surgical treatment of patients with extensive combined defects of the maxillofacial region. The dermal-fat area of the fibula bone flap is taken simultaneously with the resection stage of the operation. At the first stage, a skin incision is made on the lateral surface of the lower leg, the incision line should pass in the view of the location of the fibula, and in the area of sampling the bone part of the free flap, the incision is displaced anteriorly by 2–3 cm, then the soft tissues are dissected to the common muscle fascia. After that, a dermal-fat flap is formed along its bone part, the flap is mobilized to the posterior intermuscular septum, in which perforating vessels are determined. After that, taking into account the volume of the defect obtained during surgical resection, the exact size of the dermal-fat area of the free flap required for the reconstruction of the defect is determined, it is de-epidermised and isolated with the inclusion of the common muscle fascia and the posterior intermuscular septum with perforating vessels passing through it.

EFFECT: method allows to intraoperatively determine the design of the dermal-fat area based on the assessment of the volume of the resection stage of the operation and the location of the vessels supplying the skin-fat area, which allows to reduce the time spent on the operation due to the simultaneous resection stage of the operation and the beginning of the sampling of the free flap, as well as to reduce the frequency of failures and complications associated with the atypical arrangement of perforating vessels of the lower extremity.

1 cl, 2 dwg, 1 ex