Application of deep femoral artery third perforating artery flap for reconstruction of soft tissue defect in lower limles

Objective To investigate the feasibility and clinical effects of deep femoral artery third perforating artery perforator flap for reconstruction of soft tissue defect in lower limbs. Methods From September, 2008 to October, 2016, 8 cases of soft tissue defect in lower limbs which were repaired by deep femoral artery third perforating artery perforator flap, including 4 cases of traffic accident trauma, 2 cases of chronic ulcer, 1 case of a fall injury, 1 case of the scar after fracture operation. The area of wounds was 8.0 cm×7.0 cm-19.0 cm×8.0 cm. Seven patients were accompanied by different degrees of infections. The deep femoral artery third perforating artery perforator flap was designed to repair, including 5 cases of pedicled flaps and 3 cases of free flaps. The flap’s appearance, color, texture, infection recurrence and the recovery of lower limb function were recorded at 1, 3, 6, 9 and 12 months followed-up. Results One flap suffered partial necrosis due to cross-zone backflow disorder, the ipsilateral medial sural artery pedicled perforator flap was used to repair. The rest of the flaps survived successfully. Skin graft was used to close the donor site in 1 case, and other donor sites were closed directly. All patients had no postoperative hematoma or secondary infection. The followed-up periods ranged from 2 to 28 months (mean, 8.1 months). All flaps had satisfied appearance and texture. There were no complications such as paresthesia and numbness in the donor sites. And no motion limitations in hip and knee joint of the operated leg. Conclusion Deep femoral artery third perforating artery perforator flap can be used for both free flaps and pedicled flaps, which is a feasible method to repair soft tissue defect in lower limbs. Key words: Perforator flap; Deep femoral artery; Third perforating artery; Lower limb; Soft tissue defect