Ultrasound-guided Nerve Block for Skin Grafting on Large Diabetic Ulcer of Foot and Leg: A Technical Report

Jae-Hwang Song; Chan Kang; Deuk-Soo Hwang; Jung-Mo Hwang

doi:10.14193/jkfas.2014.18.3.133

Journal List > J Korean Foot Ankle Soc > v.18(3) > 1043305

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Song, Kang, Hwang, and Hwang: Ultrasound-guided Nerve Block for Skin Grafting on Large Diabetic Ulcer of Foot and Leg: A Technical Report

Technical Report

J Korean Foot Ankle Soc 2014;18(3):133-136.

Published online: 19 September 2014

DOI: https://doi.org/10.14193/jkfas.2014.18.3.133

Ultrasound-guided Nerve Block for Skin Grafting on Large Diabetic Ulcer of Foot and Leg: A Technical Report

Jae-Hwang Song, Chan Kang, Deuk-Soo Hwang, Jung-Mo Hwang

Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea

Corresponding Author: Chan Kang Department of Orthopaedic Surgery, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea Tel: 82-42-280-8381, Fax: 82-42-252-7098, E-mail: faschan@daum.net

Received 24 May 201412 August 2014 Accepted 13 August 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Skin grafting is often required for diabetic ulcerative foot lesions. In skin grafting, effective regional or local anesthesia into the donor and recipient areas plays a significant role in continuous control of pain. We report on a technique of ultrasound-guided nerve block on the femoral, sciatic, and lateral femoral cutaneous nerves in large split-thickness skin grafting for ulcer of the foot and leg.

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Keywords: Skin graft, Ultrasound-guided nerve block, Lateral femoral cutaneous nerve, Femoral nerve, Sciatic nerve

REFERENCES

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10.Kang C., Hwang DS., Kim YM., Kim PS., Jun YS., Hwang JM, et al. Ultrasound-guided femorosciatic nerve block by orthopaedist for ankle fracture operation. J Korean Foot Ankle Soc. 2010. 14:90–6.

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Figure 1.

Skin grafting is needed for the ulcerative legion of foot and leg after improvement of the soft tissue.

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Figure 2.

A needle is approaching to the LFCN medial to ASIS under ultrasound guidance. LFCN: lateral femoral cutaneous nerve, ASIS: anterior superior iliac spine, Med.: medial, Lat.: lateral.

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Figure 3.

(A) In supine position, an ultrasound probe is used to find the femoral nerve in femoral triangle. (B) Femoral nerve is located lateral to the femoral artery in femoral triangle. Med.: medial, Lat.: lateral.

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Figure 4.

(A) With the hip joint in 30^o∼ 45^o flexion, an ultrasound probe is placed on the posterior surface of thigh to detect the sciatic nerve. (B) Anesthetic fluid was injected where the tibial nerve and peroneal nerve merge with sciatic nerve under ultrasound guidance. Med.: medial, Lat.: lateral.

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Figure 5.

After ice test and pin prick test, the area of anesthesia was marked with skin pen as a donor-site on the left thigh.

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Figure 6.

The large ulcerative lesion was completely healed at 5 months after the surgery.

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