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Maximizing the Flap Inflow in a Foot Reconstruction: Ultrasonographic Evaluation of Artery Flow in Accordance with the Angle of the Ankle

Authors
 Young Chul Suh  ;  Hyung Bae Kim  ;  Erin Brown  ;  Joon Pio Hong  ;  Hyunsuk Peter Suh 
Citation
 PLASTIC AND RECONSTRUCTIVE SURGERY, Vol.148(2) : 258e-261e, 2021-08 
Journal Title
PLASTIC AND RECONSTRUCTIVE SURGERY
ISSN
 0032-1052 
Issue Date
2021-08
MeSH
Adult ; Ankle / blood supply ; Female ; Foot / blood supply* ; Foot / surgery ; Foot Injuries / surgery* ; Free Tissue Flaps / transplantation* ; Healthy Volunteers ; Humans ; Male ; Patient Positioning / methods* ; Reconstructive Surgical Procedures / methods* ; Regional Blood Flow ; Tibial Arteries / diagnostic imaging ; Tibial Arteries / physiology ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Pulsed
Abstract
Adequate arterial inflow is mandatory for a successful free tissue transfer. Maximizing this inflow appears to be especially important during distal lower extremity reconstruction, where perfusion pressures can be significantly lower than in the trunk or head and neck. In the current study, the authors used color and pulsed-wave Doppler ultrasonography to analyze blood flow volumes in the foot in accordance with the ankle position. Twenty feet of 10 healthy subjects were included in the analyses. All subjects were examined by Doppler ultrasonography at three different ankle angles (dorsiflexion at 90 degrees, relaxed position, and complete plantar flexion). The average flow volumes of the dorsalis pedis artery varied dramatically at the different ankle positions, as follows: dorsiflexion, 19.81 ± 3.88 ml/minute; relaxed position, 11.71 ± 4.72 ml/minute; and plantar flexion, 3.47 ± 1.41 ml/minute. The average flow volume of the posterior tibial artery also varied dramatically at these different ankle positions: dorsiflexion, 9.08 ± 8.25 ml/minute; relaxed position, 14.78 ± 2.45 ml/minute; and plantar flexion, 19.03 ± 5.03 ml/minute. The ankle position dramatically affects the flow velocity in the anterior and posterior tibial vessels, which is an important consideration when performing free tissue transfer reconstruction of the foot. Ankle dorsiflexion would be recommended when using the anterior tibial artery as a recipient vessel, whereas plantar flexion of the ankle would be advised when the posterior tibial artery is used as a recipient vessel.
Full Text
https://journals.lww.com/plasreconsurg/Fulltext/2021/08000/Maximizing_the_Flap_Inflow_in_a_Foot.31.aspx
DOI
10.1097/PRS.0000000000008176
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Suh, Young Chul(서영철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187728
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