Microvascular Transfer of The Dorsalis Pedis Skin Flap for Hypopharyngeal Reconstruction



Microvascular Transfer of The Dorsalis Pedis Skin Flap for Hypopharyngeal Reconstruction


R. M. ZUKER

R. T. MANKTELOW



The dorsalis pedis skin flap can be used for lining in most areas of the head and neck, but it is particularly useful for areas of difficult access (1, 2, 3, 4). The pharyngoesophageal area is often difficult to reconstruct with conventional pedicle flaps, but it poses no problem when a free flap is used (5, 6, 7).




ANATOMY

See Chapter 548 (8, 9).


FLAP DESIGN AND DIMENSIONS

The procedure should be planned in reverse, even though the extent of the defect is not precisely known. One should know, however, whether a portion of the anterior or posterior wall can be preserved. The more likely side of available recipient vessels is chosen, and then the more appropriate foot is selected. (For example, with a hypopharyngeal defect with a residual posterior wall and vessels likely on the right, select the left foot.)

The flap can extend distally to the interdigital web spaces (10). Its proximal extent is to the distal portion of the extensor retinaculum. Its lateral boundaries are 1 cm medial to the extensor hallucis longis tendon and 1 cm lateral to the extensor digiti quinti tendon (Fig. 228.1B).

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Jun 26, 2016 | Posted by in General Surgery | Comments Off on Microvascular Transfer of The Dorsalis Pedis Skin Flap for Hypopharyngeal Reconstruction

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