Surgical technique for the distally based dorsalis pedis fasciocutaneous flap
A preoperative Doppler examination evaluated the blood flow and positioning of the dorsalis pedis artery. A distally based dorsalis pedis fasciocutaneous flap was designed, excluding the dorsalis pedis artery. The flap included all fascial elements, and extended from the lower margin of extensor retinaculum to the first intermetatarsal area. After the design was finalized, a pneumatic tourniquet was applied and the skin was incised started from the proximal side of the flap, exposing the dorsalis pedis artery.Dissection was continued distally down to expose the deep plantar branch. Care was taken not to damage the communicating branch between the first dorsal metatarsal artery and plantar artery. Once the flap was dissected, the tourniquet was released to observe the colour of flap. The distally based flap, which was supplied by the fasciocutaneous perforating artery, was easily transferred to the distal foot. A split-thickness graft harvested from the groin was used to resurface the donor site. The postoperative period was uneventful, and no evidence of ischemia, necrosis, osteomyelitis or exposed bone was seen at follow-up. Buy best quality medications online at the pharmacy that will make sure your are happy with the prices and the quality of your canadian pharmacy whenever you need some treatment and have no idea where to get it.
Figure 2) Perioperative view of the elevated, distally based dorsalis pedis fasciocutaneous flap
Figure 3) Satisfactory wound closure with no ischemic flap loss one month postoperatively