Peroneal Flap: Clinical Application and Cadaveric Study.

Authors:
Kwan Koo Yeo
Kwan Koo Yeo
Kangbuk Samsung Hospital
Sang-Ha Oh
Sang-Ha Oh
Chungnam National University
South Korea

Arch Plast Surg 2017 Mar 15;44(2):136-143. Epub 2017 Mar 15.

Department of Plastic and Reconstructive Surgery, Chungnam National University, Daejeon, Korea.; Brain Research Institute, Chungnam National University School of Medicine, Daejeon, Korea.

Background: The goal of this study was to investigate the anatomy of the peroneal artery and its perforators, and to report the clinical results of reconstruction with peroneal artery perforator flaps.

Methods: The authors dissected 4 cadaver legs and investigated the distribution, course, origin, number, type, and length of the perforators. Peroneal artery perforator flap surgery was performed on 29 patients.

Results: We identified 19 perforators in 4 legs. The mean number of perforators was 4.8 per leg, and the mean length was 4.8 cm. Five perforators were found proximally, 9 medially, and 5 distally. We found 12 true septocutaneous perforators and 7 musculocutaneous perforators. Four emerged from the posterior tibia artery, and 15 were from the peroneal artery. The peroneal artery perforator flap was used in 29 patients. Retrograde island peroneal flaps were used in 8 cases, anterograde island peroneal flaps in 5 cases, and free peroneal flaps in 16 cases. The mean age was 59.9 years, and the defect size ranged from 2.0 cm×4.5 cm to 8.0 cm×8.0 cm. All the flaps survived. Five flaps developed partial skin necrosis. In 2 cases, a split-thickness skin graft was performed, and the other 3 cases were treated without any additional procedures.

Conclusions: The peroneal artery perforator flap is a good alternative for the reconstruction of soft tissue defects, with a constant and reliable vascular pedicle, thin and pliable skin, and the possibility of creating a composite tissue flap.

Download full-text PDF

Source
http://dx.doi.org/10.5999/aps.2017.44.2.136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366520PMC
March 2017
2 Reads

Publication Analysis

Top Keywords

peroneal artery
24
artery perforator
16
perforator flap
12
peroneal flaps
12
flaps cases
12
peroneal
10
length perforators
8
island peroneal
8
artery peroneal
8
perforators
7
artery
7
cases
5
flaps
5
cases age
4
proximally medially
4
free peroneal
4
cases free
4
anterograde island
4
age 599
4
599 years
4

Similar Publications

[Repair of soft tissue defects of lower extremity by using cross-bridge contralateral distally based posterior tibial artery perforator flaps or peroneal artery perforator flaps].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2011 Jul;25(7):826-9

Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P.R.China.

Objective: To discuss the feasibility of repairing soft tissue defects of lower extremity with a distally based posterior tibial artery perforator cross-bridge flap or a distally based peroneal artery perforator cross-bridge flap.

Methods: Between August 2007 and February 2010, 15 patients with soft tissue defect of the legs or feet were treated. There were 14 males and 1 female with a mean age of 33. Read More

View Article
July 2011

Inferior Cubital Artery Perforator Flap for Soft-Tissue Coverage of the Elbow: Anatomical Study and Clinical Application.

J Bone Joint Surg Am 2016 Mar;98(6):457-65

Service de Chirurgie Réparatrice et de la Main (O.C., R.F., C.C., J.F., T.B., C.G.), Service de Traumatologie (F.de P., N.B.), and Service d'Orthopédie (P.B.), CHU de Nice, Nice, France Laboratoire d'Anatomie Humaine, Faculté de Médecine de Nice, Nice, France.

Background: Soft-tissue defects surrounding the elbow can be a challenging problem for the orthopaedic surgeon. Reliable reconstruction with use of muscular flaps or even perforator flaps derived from the surrounding vessels has been described. The inferior cubital artery (ICA) is an indirect septocutaneous perforator branch that most frequently arises from the lateral side of the radial artery. Read More

View Article
March 2016

Perforator Peroneal Artery Flap for Tongue Reconstruction.

J Maxillofac Oral Surg 2017 Mar 11;16(1):123-126. Epub 2016 Jul 11.

Department of Head Neck Surgical Oncology, 6th Floor, Mazumdar Shaw Medical Centre, Narayana Health, 258/A Bommasandra Industrial Area, Anekal Taluk, Hosur Road, Bangalore, 560 099 India.

Introduction: Reconstruction has evolved long way from primary closure to flaps. As time evolved, better understanding of vascularity of flap has led to the development of innovative reconstructive techniques. These flaps can be raised from various parts of the body for reconstruction and have shown least donor site morbidity. Read More

View Article
March 2017

An anatomic study of the superficial peroneal nerve accessory artery and its perforators, and clinical application of superficial peroneal nerve accessory artery perforator flaps.

Ann Plast Surg 2008 Jun;60(6):710-6

Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, College of Medicine and Hospital, Gyeongsang National University, Jinju, Republic of Korea.

In the 1990s, skin island flaps supplied by the vascular axis of sensitive superficial nerves, like the sural and saphenous nerves, were introduced. Flaps supplied by the superficial peroneal nerve accessory artery (SPNAA), however, are still not commonly used. The aim of this study is to understand the anatomic structure of the SPNAA and its perforators in the anterior intermuscular septum and to use SPNAA perforator flaps in the clinic. Read More

View Article
June 2008