Distribution Of The Perforators Of The Leg And Application Of The Horn Shaped Fascio-cutaneous Perforator Flap

Objective To explore the distribution of the perforators and application of the hornshaped fascio-cutaneous flap for the middle or small defect of low leg. To elevate thefunctional effect of the soft tissue defect in the lower limb, enlarge the the applicationscope of perforator flap, reduce the operation complication and improve the qualityof patients’ life.Methods The experiment and clinical application was accomplished from January in2011to March in2012.20randomly selected healthy adults, in which8cases aremale,12cases are female, age from18to50years, body weight from45to80Kg,lower leg length from34to41cm,average length is35cm.20adults were selected todetect the distribution of perforators of low leg by Doppler. The location were fromthe line with capitulum fibulae and tibial tuberosity to the medial and lateral malleolesarea.13cases,in which4cases are male,9cases are female, age from25to75years,were covered the defects with horn shaped fascio-cutaneous flap in the leg,such assquamous cell carcinoma, basal cell carcinoma, angioneoplasm, trauma and so on.Results7650perforator points were detected on the skin surface of low leg in20adults and382points were detected on every leg. Perforators were found within threedistinct: at4-10cm,14-20cm, and24-30cm from the intermalleolar line. Surgicalrepair of soft tissue defect size of about3.0cm×10.0cm-5.0cm×16.0cm.13caseswere treated. Vascular deficiency happened at the distal end of one flap. All the other12flaps survived. All the flaps are survived completely without any complications. The appearance and functional results were satisfactory with following up for6to24months.Conclusion According to the distribution of the perforators and the location and thesize of the leg, we design the horn shaped fascio-cutaneous perforator flap to repairlower extremity soft-tissues defects. In the flap, it contains1or2perforator vessels.Because of the advantages of the flap as the reliable blood supply, lesser injuriesfor donor area and simple procedure, it received extensive solicitude both onanatomic and clinic study. All in all, we believe following the development of flapsurgery and suverying the distribution of the perforators, the horn shapedfascio-cutaneous flap is simple, reliable, easy to perform and has a low complicationrate. This surgical methods which we desighed can close the defect directly and notuse skin transplantation. It also can improve the survive rate and enhance the bloodsupport. The horn shaped fascio-cutaneous flap is cosmetically acceptable andprovides an alternative and ideal technique for the the middle or small defect of lowleg.