Reconstruction of distal lower extremities defect using the free peroneal artery perforator vessel based flap

Abstract

Soft tissue defects of the distal lower extremities are challenging. The purpose of this paper is to present our experiences with the free peroneal artery perforator flap for the reconstruction of soft tissue defects of the distal lower extremity. Nine free peroneal artery perforator flaps were used to reconstruct soft tissue defects of the lower extremities between April 2006 and October 2011. All flaps were used for distal leg and foot reconstruction. Peroneal artery perforator flaps ranged in size from 2 cm × 4 cm to 6 cm × 12 cm. The length of the vascular pedicle ranged from 2 to 6 cm. Recipient vessels were: medial plantar vessels in seven cases, the dorsalis pedis vessel in one, metatarsal vessel in one. All flaps survived completely, a success rate of 100%. Advantages of this flap are that there is no need to sacrifice any main artery in the lower leg, and minimal morbidity at the donor site. This free perforator flap may be useful for patients with small to medium soft tissue defects of the distal lower extremities and feet.

A free anterolateral thigh flap and iliotibial band for reconstruction of soft tissue defects at children's feet and ankles

“…Ideally, when tissue is lost, similar tissue should be used for reconstruction. Traditional treatment is to use pedicle skin flaps or local transposition flaps to repair soft tissue defects, but availability of local donor tissues is quite limited, especially at the foot and ankle [8][9][10][11]. Moreover, when bone or tendon is exposed with gross tissue loss, local flaps cannot provide coverage.…”

“…Moreover, when bone or tendon is exposed with gross tissue loss, local flaps cannot provide coverage. An alternative is to use free flaps [10][11][12][13][14]. Our goals for reconstructive surgery were to provide: (1) a tendon reconstruction that could withstand the mechanical and shear forces required for normal function, such as standing, walking and running; (2) vascularised soft tissue that could fill a cavity, cover a wound and protect healing and smooth movement of tendons; and (3) durable skin coverage for an injured foot to wear shoes and move [15].…”

Peroneal perforator‐based peroneus longus tendon and sural neurofasciocutaneous composite flap transfer for a large soft‐tissue defect of the forearm: A case report

“…This modification may make the elevation of a large skin paddle safer and allow freedom in design of the composite flap, in which there was no posterior crural septum attached to the skin paddle. As necrosis of the distal part of the peroneal perforator flap is a common complication (Ozkan, Ozkan, Cinpolat, & Bektas, 2014;Seo, Kim, & Yoon, 2015), the peroneal flap is suitable for the reconstruction of small-to medium-sized soft-tissue defects (Scaglioni, Kuo, & Chen, 2016). There are two possible reasons for the necrosis of the peroneal flap.…”

Value of a smartphone‐compatible thermal imaging camera in the detection of peroneal artery perforators: Comparative study with computed tomography angiography

“…Initially, PAP flaps were designed as pedicled flaps for regional defects . As a free flap, it has been used for lower and upper extremity reconstructions …”

“…[5][6][7] As a free flap, it has been used for lower and upper extremity reconstructions. 8,9 Recently, PAP flaps have been applied for intraoral reconstruction due to its thin and palpable nature. It has a long pedicle with large size caliber, and the donor site morbidity is low.…”