Ha Yooseok, Yeo Kwan Koo, Piao Yibo, Oh Sang-Ha
Department of Plastic and Reconstructive Surgery, Chungnam National University, Daejeon, Korea.
Jinan Public Health Care Center, Jinan, Korea.
Arch Plast Surg. 2017 Mar;44(2):136-143. doi: 10.5999/aps.2017.44.2.136. Epub 2017 Mar 15.
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.
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.
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.
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.
本研究的目的是研究腓动脉及其穿支的解剖结构，并报告腓动脉穿支皮瓣重建的临床结果。
作者解剖了4条尸体下肢，研究穿支的分布、走行、起源、数量、类型和长度。对29例患者进行了腓动脉穿支皮瓣手术。
我们在4条下肢中发现了19个穿支。每条下肢穿支的平均数量为4.8个，平均长度为4.8厘米。近端发现5个穿支，内侧9个，远端5个。我们发现12个真正的隔皮穿支和7个肌皮穿支。4个穿支发自胫后动脉，15个发自腓动脉。29例患者采用了腓动脉穿支皮瓣。逆行岛状腓皮瓣8例，顺行岛状腓皮瓣5例，游离腓皮瓣16例。平均年龄59.9岁，缺损大小从2.0厘米×4.5厘米到8.0厘米×8.0厘米不等。所有皮瓣均存活。5个皮瓣出现部分皮肤坏死。2例进行了断层皮片移植，另外3例未进行任何额外处理。
腓动脉穿支皮瓣是重建软组织缺损的良好选择，其血管蒂恒定可靠，皮肤薄且柔软，并且有可能制作复合组织皮瓣。
