title: [APPLICATION VALUE OF DIGITAL SUBTRACTION ANGIOGRAPHY IN REPAIR OF FOOT AND ANKLE WOUNDS WITH POSTERIOR TIBIAL ARTERIAL PERFORATOR FLAP].
abstract: OBJECTIVE
  To explore the application value of digital subtraction angiography (DSA) in repairing foot and ankle wounds with posterior tibial arterial perforator flaps.
  
  
  METHODS
  Between January 2010 and May 2014, 12 cases of foot and ankle wounds were repaired using posterior tibial arterial perforator flaps. There were 7 males and 5 females with an average age of 36 years (range, 22-54 years). The causes were machine injury in 2 cases, falling injury in 3 cases, and traffic accident injury in 7 cases. The disease duration ranged from 7 to 45 days (mean, 16 days). The size of wound ranged from 6 cm x 4 cm to 10 cm x 5 cm. Preoperative DSA was performed to observe the orientation and distribution of the posterior tibial arterial perforator and the relationship between perforator vessels. Correspondently, the flaps were designed and harvested. The size of flap ranged from 7 cm x 5 cm to 11 cm x 6 cm. The donor sites were repaired with skin grafts.
  
  
  RESULTS
  Posterior tibial arterial perforator vessels send out ascending branches and descending branches while going down in the superficial layer. All branches were connected to form vertical chain-form anastamosis, and its orientation was consistent with limb vertical axis. According to DSA results, the flaps were designed and harvested easily. All flaps survived after operation. Meanwhile, wounds healed by first intention. All skin grafts at donor site survived. All patients were followed up 6 months. The flaps had good appearance, color, and texture. No ulcer was found. Affected feet had normal walking function.
  
  
  CONCLUSIONS
  The size, distribution, and chain-form anastamosis condition of the posterior tibial arterial perforator vessels can be accurately observed by DSA, which provides imaging evidence for harvesting posterior tibial arterial perforator flaps and improves the success rate for repairing foot and ankle wounds.
authors.forename: Ziyang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Wenduo
authors.initials: W
authors.lastname: Zhang
authors.forename: Zairong
authors.initials: Z
authors.lastname: Wei
authors.forename: Bihua
authors.initials: B
authors.lastname: Wu
authors.forename: Hai
authors.initials: H
authors.lastname: Li
authors.forename: Guangfeng
authors.initials: G
authors.lastname: Sun
authors.forename: Wenhu
authors.initials: W
authors.lastname: Jin
authors.forename: Xiujun
authors.initials: X
authors.lastname: Tang
authors.forename: Chengliang
authors.initials: C
authors.lastname: Deng
authors.forename: Kaiyu
authors.initials: K
authors.lastname: Nie
mesh_terms: D015901:Angiography, Digital Subtraction; D000842:Ankle; D016512:Ankle Injuries / Q000601:surgery*; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation; D017695:Soft Tissue Injuries; D013639:Tarsal Bones; D014945:Wound Healing