Clinical Applications of Peroneal Perforator Flap

비골동맥 천공지 피판의 임상적 적용

  • Oh, Sang Ha (Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Oh, Hyun Bae (Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Lee, Seung Ryul (Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Kang, Nak Heon (Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University)
  • 오상하 (충남대학교 의과대학 성형외과학교실) ;
  • 오현배 (충남대학교 의과대학 성형외과학교실) ;
  • 이승렬 (충남대학교 의과대학 성형외과학교실) ;
  • 강낙헌 (충남대학교 의과대학 성형외과학교실)
  • Received : 2005.12.19
  • Published : 2006.03.10

Abstract

The perforator flaps are based on cutaneous vessels which are originated from a main pedicle and penetrate fascia or muscle to reach the skin. The lateral lower leg is one of the most suitable areas for harvesting perforator flaps because a number of perforator vessels exist. The authors applied peroneal perforator flaps in nine patients. Five flaps were reverse island flaps based on peroneal artery and septocutaneous perforator, and four flaps were free flap based on musculocutaneous perforator only. The recipient site was the posterior ankle in three patients, posterior heel in three patients, lateral malleolus, anterolateral ankle, and foot dorsum in one patient each. The flap size ranged from 5 to 12cm long, from 3 to 5cm wide, and the primary closure of the donor site was possible in most cases. All flaps, except for the flap in two patients in the reverse island flap series, survived completely. The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized superficial skin defects. Also, this flap may be considered as an alternative to radial forearm flap or other perforator flaps.

Keywords

References

  1. Wei FC, Jain V, Suominen S, Chen HC: Confusion among perforator flaps: What is a true perforator flap- Plast Reconstr Surg 107: 874, 2001 https://doi.org/10.1097/00006534-200103000-00037
  2. Chen YL, Zheng BG, Zhu JM, Zheng BX, Gu YD, Wu MM, Li HR: Microsurgical anatomy of the lateral skin flap of the leg. Ann Plast Surg 15: 313, 1985 https://doi.org/10.1097/00000637-198510000-00007
  3. Hallock GG: Direct and indirect perforator flaps: the history and the controversy. Plast Reconstr Surg 111: 855, 2003 https://doi.org/10.1097/01.PRS.0000040462.38363.C7
  4. Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH: Have we found an ideal soft-tissue flap- An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109: 2219, 2002 https://doi.org/10.1097/00006534-200206000-00007
  5. Celik N, Wei FC, Lin CH, Cheng MH, Chen HC, Jeng SF, Kuo YR: Technique and strategy in anterolateral thigh perforator flap surgery, based on an analysis of 15 complete and partial failures in 439cases. Plast Reconstr Surg 109: 2211, 2002 https://doi.org/10.1097/00006534-200206000-00005
  6. Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K: Anatomic variations and technical problems of the anterolateral thigh flap: A report of 74 cases. Plast Reconstr Surg 102: 1517, 1998 https://doi.org/10.1097/00006534-199810000-00026
  7. Yoshimura M, Imura S, Shimamura K, Yamauchi S, Nomura S: Peroneal flap for reconstruction in the extremity: preliminary report. Plast Reconstr Surg 74: 402, 1984 https://doi.org/10.1097/00006534-198409000-00013
  8. Beppu M, Hanel DP, Johnston GH, Carmo JM, Tsai TM; The osteocutaneous fibula flap: An anatomic study. J Reconstr Microsurg 8: 215, 1992 https://doi.org/10.1055/s-2007-1006703
  9. Yajima H, Ishida H, Tamai S: Proximal lateral leg flap transfer utilizing major nutrient vessels to the soleus muscle. Plast Reconstr Surg 93: 1442, 1994 https://doi.org/10.1097/00006534-199406000-00017
  10. Wolff KD: The supramalleolar flap based on septocutaneous perforators from the peroneal vessels for intraoral soft tissue replacement. Br J Plast Surg 46: 151, 1993 https://doi.org/10.1016/0007-1226(93)90149-6
  11. Kawamura K, Yajima H, Kobata Y, Shigematsu K, Takakura Y: Clinical applications of free soleus and peroneal perforator flaps. Plast Reconstr Surg 115: 114, 2005
  12. Wolff KD, Holzle F, Nolte D: Perforator flaps from the lateral lower leg for intraoral reconstruction. Plast Reconstr Surg 113: 107, 2004 https://doi.org/10.1097/01.PRS.0000095936.56036.CD