An Anatomic Study of the Superficial Peroneal Nerve Accessory Artery and Its Perforators, and Clinical Application of Superficial Peroneal Nerve Accessory Artery Perforator Flaps
- 손대구; 최태현; 한기환; 김준형
- Alternative Author(s)
- Son, Dae Gu; Choi, Tae Hyun; Han, Ki Hwan; Kim, Jun Hyung
- Publication Year
- 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.
We dissected 16 cadavers and assessed the location and number
of the SPNAA, its perforators, and the septocutaneous perforators
originating from the anterior tibial artery. A SPNAA perforator flap
was applied to 12 patients, the free flap was applied to 11 patients,
and the pedicled flap was applied to 1 patient.
SPNAA varied from 7 to 16 cm in length, with an average of 4.5
perforators to supply the lateral aspect. An average of 3.13 septocutaneous
perforators originated from the anterior tibial artery. The
mean size of the SPNAA perforator flaps was 65.5 cm2. The
complete follow-up period was 3–20 months. Although 1 flap was
lost as a result of arterial thrombosis, the procedure was successful
in the remaining 11 patients. In addition, reduced flap thickness
made them more esthetically appealing.
SPNAA perforator flaps could be an excellent alternative to
perforator flaps that use the lower leg as a donor site.
Key Words: neurocutaneous flap, superficial peroneal nerve
accessory artery, perforator flap, anterior intermuscular septum
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