[Application of Doppler in the skin flap of vastus lateralis].

OBJECTIVE

To investigate a method of improving design of the skin flap pedicled with descending branch of lateral femoral circumflex artery, in order to increase the accuracy of preoperative Doppler location.

METHODS

Firstly, the interspace between rectus femoris and vastus lateralis was regarded as line A, and the point of intersection between line A and the vertical line through the midpoint of the line between anterior superior iliac spine and lateral margin of patella was point A. And then the line between the midpoint of groin and point A was regarded as line B. Based on this , the perforating point of cutaneous branch could be located by Doppler along the line B. From November 2001 to October 2004, this method was used in 38 skin flaps of 37 cases, being all males and 16-48 years old. The area of the flap ranged from 7 cm x 6 cm to 24 cm x 16 cm.

RESULTS

All the perforating point of cutaneous branch were located outward the line A. The rate that the preoperative Doppler location was consistent with the utility point of formatting skin flap was 97.4%. All the cases were followed up postoperatively 1-20 months. Among the cases, 36 skin flaps of 35 cases was successful and only 2 skin flaps partially necrosed, which healed after changing dressings or skin graft. Out of 35 cases, the sensation restoration of the skin flap was S2-S3 in 6 cases owing to the anastomosis of lateral femoral cutaneous nerve and a skin nerve of the recipient site, while that of the other cases was S0-S1.

CONCLUSION

Preoperative Doppler location and improving design of line B can be a useful instruction for the design of skin flap pedicled with descending branch of lateral femoral circumflex artery.