title: Dorsalis Pedis Adipofascial Perforator flap for great toe reconstruction: anatomical study and clinical applications.
abstract: Defects of the dorsum of the foot can be challenging to reconstruct, none more so than the dorsum of the toe. The reverse Dorsalis Pedis Adipofascial Perforator (DPAP) flap is one possible reconstructive option for defects in this region. The aim of this study was to first demonstrate the anatomy of this flap, particularly the consistency of the perforators arising from the dorsalis pedis artery. Second, we present a clinical series based on this flap to demonstrate how it can be used. For the anatomical studies, 22 fresh cadaveric lower extremities were dissected, and injection studies were used to delineate the vascular territories. The presence of the distal perforator, distance to the first metatarso-phalangeal joint and diameter of each perforator were recorded. The cadaveric studies confirmed the presence of distal perforators to the first metatarso-phalangeal joint in 100% of limbs examined. The clinical study demonstrated the feasibility of the use of the adipofascial turn-over perforator flap for dorsal foot reconstruction. These anatomic findings provide an alternative method of reconstruction of great toe defects using the reverse DPAP flap.
authors: Plastic Reconstructive and Aesthetic Surgery Unit, University of Messina, Policlinico 'G. Martino', Via Consolare Valeria 1, 98125 Messina, Italy.
authors: A
authors: A
authors: Russo
authors: Plastic Reconstructive and Aesthetic Surgery Unit, University of Messina, Policlinico 'G. Martino', Via Consolare Valeria 1, 98125 Messina, Italy. Electronic address: gabrieledelia@gmail.com.
authors: G
authors: G
authors: Delia
authors: Plastic and Burn Unit Fx Michelet Center, Bordeaux Segalen University, Bordeaux, France.
authors: V
authors: V
authors: Casoli
authors: Plastic Reconstructive and Aesthetic Surgery Unit, University of Messina, Policlinico 'G. Martino', Via Consolare Valeria 1, 98125 Messina, Italy.
authors: M R
authors: MR
authors: Colonna
authors: Plastic Reconstructive and Aesthetic Surgery Unit, University of Messina, Policlinico 'G. Martino', Via Consolare Valeria 1, 98125 Messina, Italy.
authors: F
authors: F
authors: Stagno d'Alcontres
mesh_terms: D000368:Aged; D002102:Cadaver; D006214:Hallux / Q000293:injuries / Q000601:surgery*; D006801:Humans; D061525:Perforator Flap / Q000098:blood supply / Q000294:innervation; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D055815:Young Adult
keywords: Adipofascial flap; Dorsal foot reconstruction; Dorsalis pedis artery perforator; Perforator flap