DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20192125

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

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.

Keywords


Angiosome, Digital tip injury, Hand surgery, Neurocutaneous transfer

Full Text:

PDF

References


Vergara Dagobeth E, Castillo Burgos L, Vergara Garcían S. El Concepto Anatómico De Angiosoma: Aplicaciones En Clínica Quirúrgica. Revisalud Unisucre. 2013;1(2):139-41.

Taylor GI, Corlett RJ, Ashton MW. The functional angiosome: clinical implications of the anatomical concept. Plast Reconstr Surg. 2017;140(4):721-33.

Scheker LR1, Becker GW. Distal finger replantation J Hand Surg Am. 2011;36(3):521-8.

Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987;40(2):113-41.

Koshima I1, Yamamoto T, Narushima M, Mihara M, Iida T. Perforator flaps and supermicrosurgery. Clin Plast Surg. 2010 Oct;37(4):683-9.

Singh M, Saxena A. Microsurgery: A Useful and Versatile Tool in Surgical Field. Surgery Curr Res. 2014;4:194.

Rodríguez-Vegas JM, Roger-De-Oña I, Ruíz-Alonso E, Carosini-Ruíz-Díaz R. Transferencia microquirúrgica hemipulpar del hallux en la reconstrucción del pulgar. Cir. Plást. iberolatinoam. 2017;43-Supl. 1:S37-S44.

Del Piñal F, García-Bernal FJ, Regalado J, Studer A, Cagigal L, Ayala H. The tibial second toe vascularized neurocutaneous free flap for major digital nerve defects. J Hand Surg Am. 2007 Feb;32(2):209-17.

Del Piñal F, García-Bernal FJ, Ayala H, Cagigal L, Studer A, Regalado J. Reconstrucción de pérdidas de sustancia de pulpejo. Trauma Fund MAPFRE. 2008;19(2):69-73.

Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987 Mar;40(2):113-41.