[Anatomic basis and clinical application of modified peroneal arterial cutaneous branch nutritional flap]

To observe the anatomic basis and the clinical application of the modified peroneal arterial cutaneous branch nutritional flap.

Twenty sides of lower limb of adult colyseptic cadavers and 5 sides of lower limb of adult fresh cadavers were used to detect the cutaneous branches of the peroneal artery. The position where the cutaneous branches come from the peroneal artery and the diameter of the cutaneous branches were recorded. From September 2003 to June 2005, 10 cases of skin and soft tissue defects in the region of metatarsophalangeal point with the modified peroneal arterial cutaneous branch nutritional flap, in which the cutaneous branches from the peroneal artery 11.0 +/- 1.7 cm upon the lateral malleolus were added. The defect size was 10 cm x 6 cm to 15 cm x 10 cm. The flap size was 11.0 cm x 6.5 cm to 16.0 cm x 11.0 cm.

There is a stable cutaneous branches from peroneal artery 11.0 +/- 1.7 cm upon the lateral malleolus. The diameter of this cutaneous branches at the origin is 1.45 +/- 0.12 mm. The distance between the cutaneous branches entrance of the deep fascia and the line of the sural nerve nutritional artery flap was 15.70 +/- 1.20 mm. All 10 flaps survived. The blood supply and venous return of the skin flaps were good. The 10 patients were followed up from 6 to 12 months. The shape of the flaps was satisfactory. The texture and the color and luster of the flaps were similar to the adjacent skin. The functions of the feet were good. The two-point discrimination was 11-18 mm.

The modified peroneal arterial cutaneous branch nutritional flap has good blood supply. It can reverse to a long distance and can repair large skin defects.