The free peroneal perforator-based sural neurofasciocutaneous flap: anatomical study and clinical application
10.3760/cma.j.issn.1001-2036.2010.04.003
- VernacularTitle:腓动脉穿支蒂腓肠神经营养血管长轴皮瓣的应用解剖及其临床应用
- Author:
Yimin CHAI
;
Chunyang WANG
;
Jizhong YE
;
Gen WEN
;
Peihua CAI
;
Bingfang ZENG
- Publication Type:Journal Article
- Keywords:
Peroneal artery;
Perforator;
Sural nerve;
Neurofasciocutaneous flap;
Microsurgery
- From:
Chinese Journal of Microsurgery
2010;33(4):268-270,后插一
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report the anatomical study and clinical application of the free peroneal perforator-based sural neurofasciocutaneous flap. Methods Latex injection studies were performed on 10 adult cadaveric lower limbs. The presence, prevalence, and location of the peronel perforators that were suitable for vascular anastomosis were documented. From April 2007 to January 2010, 6 patients with large soft tissue defects in the upper limb underwent the reconstructive procedures with the free peroneal perforatorbased sural neurofasciocutaneous flap transfers. 4 patients were men and 2 were women, with the age ranging from 19 to 60 years. The causes of the injury included 4 motor vehicle accidents, and 2 massive machinery trauma. The area of the flap ranged from 16 cm × 8 cm to 30 cm × 10 cm, and the length of the perforator pedicle was 4 cm to 6 cm. Results A mean of 5.3 perforating vessels of the peroneal artery was noted in the specimen. The peroneal perforator that located at the junction of the middle and lower thirds of the fibula was found suitable for microsurgery, with the external diameter and the length being (1.21 ± 0.13)mm and (4.6 ± 0.8)cm respectively. All the 6 flaps survived completely without necrosis. No severe venous congestion was observed. All the patients were satisfied with the aesthetic outcome postoperatively at 3 to 12 months'follow-up. There were no major donor site complications. Conclusion The free sural neurofasciocutaneous flap based on a single peroneal perforator is an excellent tool for reconstruction of extensive soft tissue defects in the upper limb.
