Angiosome study of the first digital feet space, for reconstruction of the digital tip

Banegas Ruiz Rodrigo; Espejel Blancas José Alejandro; Baca Domínguez Carlos Rubén; Campos Angulo Gerardo; Luis Jesús Alejo Fuentes; Francisco Fabián Gómez Mendoza; Juan Pablo Espinoza Torres; Luis Rodrigo Carazo Quiroz; Víctor Manuel Ramos Lojero; Valderrama Treviño Alan Isaac; Barrera Mera Baltazar

doi:10.18203/2320-6012.ijrms20192125

Authors

Banegas Ruiz Rodrigo Department of Hand Surgery and Microsurgery, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX, Mexico
Espejel Blancas José Alejandro Angiology and Vascular Surgery Service, Hospital Angeles Metropolitano, CDMX, Mexico
Baca Domínguez Carlos Rubén Department of Hand Surgery and Microsurgery, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX, Mexico
Campos Angulo Gerardo Department of Hand Surgery and Microsurgery, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX, Mexico
Luis Jesús Alejo Fuentes Department of Hand Surgery, Hospital Angeles Centro Médico del Potosí, SLP, Mexico
Francisco Fabián Gómez Mendoza Department of Hand Surgery, Central Military Hospital, CDMX, Mexico
Juan Pablo Espinoza Torres Department of Pediatric Plastic and Reconstructive Surgery, HGCMN La Raza, IMSS, CDMX, Mexico
Luis Rodrigo Carazo Quiroz Department of Plastic and Reconstructive Surgery, CMNSXXI, IMSS, CDMX, Mexico
Víctor Manuel Ramos Lojero Department of Sanitary Jurisdiction, Health Services in Alvaro Obregon, CDMX, Mexico
Valderrama Treviño Alan Isaac Department of Experimental Immunotherapy and Tissue Engineering, Faculty of Medicine, UNAM, CDMX, Mexico
Barrera Mera Baltazar Department of Physiology, Faculty of Medicine, UNAM, CDMX, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20192125

Keywords:

Angiosome, Digital tip injury, Hand surgery, Neurocutaneous transfer

Abstract

Background: The concept of angiosome explains the anatomical variations that exist between the vessels of different regions of the body and helps to understand the contributions of arterial blood supply to the skin and adjacent structures, dividing the human body into three-dimensional vascular blocks.

Methods: This was an observational and descriptive study. In both lower extremities of 5 corpses with adequate tissue preservation in the operating room attached to the teaching area of the National Institute of Forensic Sciences in Mexico City. Angiosome study of the medial neurocutaneous flap of the second toe of both feet was performed.

Results: The average, in centimeters, of the surface of the flaps was 1.57 cm x 2.47 cm, the average diameter of the inter-metatarsal digital artery was 1.1 millimeters and the average diameter of the veins draining the angiosome was 1.4 millimeters. The most constant anatomy was that of the nerve, which was present in all cases, with the digital nerve forming the neurosome of the flap.

Conclusions: To obtain optimal results in microsurgery transfers, it is necessary to have a technique that is quick for harvesting the flap and with adequate systematization so as not to injure the neurovascular bundle, this is achieved through complete anatomical knowledge, without forgetting the main variants.

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