Journal of Tissue Engineering and Reconstructive Surgery ›› 2023, Vol. 19 ›› Issue (5): 446-.

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Posterior tibial artery perforator flap assisted by DSA and Doppler ultrasound in the repair of skin and soft tissue defects in the lower leg

  

  • Online:2023-10-09 Published:2023-10-31

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Abstract:

Objective　To explore the effect of using DSA and Doppler ultrasound to design posterior tibial artery perforator
flap in the repair of soft tissue defect of the lower leg. Methods　From January 2020 to December 2022, 5 cases of lower leg
soft tissue defects were treated with a cutaneous branch of the posterior tibial artery flap. Preoperatively, digital subtraction an
giography (DSA) were used to confirm the course of the posterior tibial artery and the location of the penetrating branch, and the
dominant perforating branch was selected. Doppler ultrasound confirmed the location of the dominant perforating branch, and
the skin flap was designed based on the location and area of the wound, followed by skin flap transplantation. The donor flap area
was covered with skin grafting. Results　DSA examination showed that among the 5 patients, 2 had no damage to the main blood
vessels of the lower leg, and 3 had distal occlusion of the anterior tibial artery. All 5 patients showed perforating branches of the
posterior tibial artery. Five cases of flaps and grafted skin sheets survived. After 6-12 months of follow-up, the appearance of the
affected area was satisfactory, and the function of the leg and ankle joint recovered. Conclusion　Using DSA to observe the per
forating branch of posterior tibial artery and select the dominant perforating branch, combined with Doppler ultrasound to guide
the design of skin flap, good results can be obtained in the repair of the anterior and medial wounds of the lower leg.

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