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. 2023 Sep 8;31(spe3):e267572.
doi: 10.1590/1413-785220233103e267572. eCollection 2023.

DORSALIS PEDIS NEUROVASCULAR FLAP, OUR EXPERIENCE

Sérgio Aparecido do Amaral  1 , Bárbara Letícia Ferreira de Carvalho  1 , Antonio Clodoildo Andrade  1 , Maurício Benedito Ferreira Caetano  2 , Luiz Angelo Vieira  3 , Edie Benedito Caetano  3
Affiliations

DORSALIS PEDIS NEUROVASCULAR FLAP, OUR EXPERIENCE

Sérgio Aparecido do Amaral et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Objectives: Analyze the donor site morbidity of the dorsalis pedis neurovascular flap in traumatic injuries with hand tissue loss.

Material and methods: The study involved dorsalis pedis neurovascular flaps that were used to reconstruct the hands of eight male patients, between 1983 and 2003, aged between 21 and 53 years (mean 34.6, SD ± 10.5 years). The size of the lesions ranged from 35 to 78 cm2 (mean 53, SD ± 14.4 cm2). Surgical procedures were performed two to 21 days after the injuries had occurred. The patients were followed up for an average of 10.3 years (ranging 8-14, SD ± 2.1 years).

Results: Regarding the donor site, in one case there was hematoma formation, which was drained; in another case, the skin graft needed to be reassessed. All patients experienced delayed healing, with complete healing from 2 to 12 months after the surgery (mean 4.3, SD ± 3.2 months).

Conclusion: Despite the advantages of the dorsalis pedis neurovascular flap, we consider that the sequelae in the donor site is cosmetically unacceptable. Nowadays, this procedure is only indicated and justified when associated with the second toe transfer. Level of Evidence IV; Case series .

Objetivos: Analisar a morbidade da área doadora do retalho neurovascular do dorso do pé em lesões traumáticas com perda de tecido da mão.

Material e métodos: O estudo envolveu retalhos neurovasculares do dorso do pé usados para reconstruir as mãos de oito pacientes do sexo masculino, entre 1983 e 2003, com idades entre 21 e53 anos (média de 34,6, DP ± 10,5 anos). O tamanho das lesões variou de 35 a 78 cm2 (média de 53, DP ± 14,4 cm2). Os procedimentos cirúrgicos foram realizados entre dois a 21 dias após a ocorrência das lesões. Os pacientes foram acompanhados por uma média de10,3 anos (variando de 8 a 14, DP ± 2,1 anos).

Resultados: Quanto ao local doador, em um caso houve formação de hematoma, que foi drenado; em outro caso, o enxerto de pele precisou ser reavaliado. Todos os pacientes apresentaram retardo na cicatrização, com cicatrização completa de 2 a 12 meses após a cirurgia (média de 4,3, DP ± 3,2 meses).

Conclusão: Apesar das vantagens do retalho neurovascular do dorso do pé, consideramos que as sequelas no local doador são cosmeticamente inaceitáveis. Atualmente, esse procedimento só é indicado e justificado quando associado à transferência do segundo dedo do pé. Nível de evidência IV; Série de casos .

Keywords: Foot; Lower Extremity; Postoperative Complications; Surgical Flaps; Upper Extremity.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Dorsalis pedis neurovascular flap covering the palm of the hand.
Figure 2
Figure 2. Dorsalis pedis neurovascular flap associated with the first commissure to properly cover the radial side of the hand and middle finger.
Figure 3
Figure 3. Dorsalis pedis neurovascular flap associated with the transfer of the second toe.
See this image and copyright information in PMC

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