Article Sidebar

article details
Date Published: 31/10/2023
Online Published: 31/10/2023
Abstract Views: 250
Views article details: 236
DOI: https://doi.org/10.54804/yhthvb.5.2023.268
Issue
No. 5 (2023)
Section
Articles
How to Cite
Tran, D. T. D., Nguyen, T. X., Nguyen, D. H., Nguyen, P. D. P., & Hoang, T. H. (2023). Application of reverse first dorsal metatarsal artery to treat soft tissue defect of great toe. Journal of Disaster Medicine and Burn Injuries, 5, 98-106. https://doi.org/10.54804/yhthvb.5.2023.268

Application of reverse first dorsal metatarsal artery to treat soft tissue defect of great toe

Tran Dinh Truong Dat1, Nguyen Thanh Xuan1, Nguyen Duc Hanh1,, Nguyen Phu Dong Phuong1, Hoang Thanh Hiep1
1 Hue Central Hospital - Base 2

Main Article Content

Abstract

Background: Distal foot and toe defects required a vascularized flap for coverage. A free flap was one of the appropriate treatment choices for this region but the use of perforator flaps helps surgeons avoid difficulties associated with microvascular tissue transfer. This report aimed to describe our experience using reverse FDMA perforator flap to cover great toe defects at Hue Central Hospital Base 2.
Methods: A standard FDMA flap from the dorsum of the foot was raised in a reversed fashion based on the distal communicating brand or perforator from the plantar foot arch in six patients with great toe defects.
Results: Great first-toe defects of all patients were salvaged. Reverse FDMA perforator flap achieved reconstructive goals and the donor site healing was achieved without tension. Only 1 case had an infection with multidrug-resistant bacteria.
Conclusions: A reverse FDMA flap can be used as a local flap to cover distal foot and toe wounds (for both elective and urgent surgeries). The donor site can be directly closed or maybe a skin graft.

Article Details

Keywords

First dorsal metatarsal artery, great toe, perforator flap

References

1. Qichang Mei, Yaodong Gu, et al, “Foot shape and plantar pressure relationships in shod and barefoot populations,” Biomechanics and Modeling in Mechanobiology, tập 19, số 4, p. 1211-1224, 2020.
2. Ishikawa K, Isshiki N, Suzuki S, et al, “Distally based dorsalis pedis island flap for coverage of the distal portion of the foot,” Br J Plast Surg, tập 40, số 5, pp. 521-525, 1987.
3. St. Laurent JY, Lanzetta M, “Resurfacing of the donor defect after wrap-around toe transfer with a free lateral forearm flap,” J Hand Surg Am, tập 22, số 5, pp. 913-917, 1997.
4. Hayashi A and Maruyama Y, “Reverse first dorsal metatarsal artery flap for reconstruction of the distal foot,” Ann Plast Surg, tập 31, số 3, pp. 117-122, 1993.
5. Roukis TS, Landsman AS, “A Simple salvage technique for single stage, soft tissue coverage of plantar first metatarsal head ulcerations and ablation of great toe osteomyelitis,” Plast Reconstr Surg, tập 113, số 3, pp. 1098-1100, 2004.
6. Butler CE and Chevray P, “ Retrograde-flow medial plantar island flap reconstruction of distal forefoot, toe, and webspace defects,” Ann Plast Surg, tập 49, số 2, pp. 196-201, 2009.
7. Giraldo F, De Haro F, and Ferrer A, “Opposed transverse extended V-Y plantar flaps for reconstruction of neuropathic metatarsal head ulcers,” Plast Reconstr Surg, tập 108, số 4, pp. 1019-1024, 2001.
8. Senyuva C, Yucel A, Fassio E, et al, “Reverse first dorsal metatarsal artery adipofascial flap,” Ann Plast Surg, tập 36, số 2, pp. 158-161, 1996.
9. Samson MC, Morris SF, Tweed AEJ, “Dorsalis pedis flap donor site: acceptable or not?,” Plast Reconstr Surg, tập 102, số 5, pp. 1549-1554, 1998.
10. Ohmori K and Harii K, “Free dorsalis pedis sensory flap to the hand, with microneurovascular anastomosis,” Plast Reconstr Surg, tập 58, số 5, pp. 546-554, 1976.
11. Yeo CJ, Sebastin SJ, Ho SY, et al, “The dorsal metatarsal artery perforator flap,” Ann Plast Surg, tập 73, số 4, pp. 441-444, 2014.
12. Hallock GG, “Distally based flaps for skin coverage of the foot and ankle,” Foot Ankle Int, tập 17, số 6, pp. 343-348, 1996.
13. Balakrishnan C, Chang YJ, Balakrishnan A, et al, “Reversed dorsal metatarsal artery flap for reconstruction of a soft tissue defect of the big toe,” Can J Plast Surg, tập 17, số 3, pp. 11-12, 2009.
14. Pignatti M, Ogawa R, Hallock GG, et al, “The “Tokyo” consensus on propeller flaps,” Plast Reconstr Surg, tập 127, số 2, pp. 716-722, 2011.
15. Hou Z, Zou J, Wang Z, et al, “Anatomical classification of the first dorsal metatarsal artery and its clinical application,” Plast Reconstr Surg, tập 132, số 6, pp. 1028-1039, 2013.
16. Lee JH and Dauber W, “Anatomic study of the dorsalis pedis first dorsal metatarsal artery,” Ann Plast Surg, tập 38, số 1, pp. 50-55, 1997.
17. Hallock GG, “The propeller flap version of the adductor muscle perforator flap for coverage of ischial or trochanteric pressure sores,” Ann Plast Surg, tập 56, số 5, pp. 540-542, 2006.
18. Hallock GG, “Attributes and shortcomings of acoustic Doppler sonography in identifying perforators for flaps from the lower extremity,” J Reconstr Microsurg, tập 25, số 6, pp. 377-381, 2009.
19. Robinson DW, “Microsurgical transfer of the dorsalis pedis neurovascular island flap,” Br J Plast Surg, tập 29, số 3, pp. 209-213, 1976.
20. Jakubietz RG, Jakubietz MG, Gruenert JG, et al, “The 180-degree perforator based propeller flap for soft tissue coverage of the distal, lower extremity: a new method to achieve reliable coverage of the distal lower extremity with a local, fasciocutaneous perforator flap,” Ann Plast Surg, tập 59, số 6, pp. 667-671, 2007.