Peroneal perforator flap for intraoral reconstruction

Area of Science:

• Plastic Surgery
• Oral and Maxillofacial Surgery
• Reconstructive Surgery

Background:

• Thin, pliable flaps with long pedicles are ideal for intraoral lining.
• The radial forearm free flap, previously preferred, has donor site complications.
• Peroneal perforator flaps are explored as an alternative reconstructive option.

Purpose of the Study:

• To evaluate the efficacy and safety of peroneal perforator flaps for intraoral reconstruction.
• To assess donor site morbidity associated with the peroneal perforator flap.
• To compare peroneal perforator flaps with existing methods for oral defects.

Main Methods:

• Thirty patients underwent intraoral reconstruction using peroneal perforator flaps.
• Preoperative Magnetic Resonance (MR) angiography identified major perforating vessels.
• Flaps were raised via a lateral approach, with direct wound closure at the donor site.

Main Results:

• All identified perforators were accessible, with most having a septocutaneous course.
• Flap survival rate was high (all but one flap survived).
• Reconstructions included floor of mouth, tongue, and buccal mucosa with satisfactory functional outcomes and low donor site morbidity.

Conclusions:

• The peroneal perforator flap, guided by MR angiography, is a safe and effective option for intraoral reconstruction.
• It is a suitable alternative for small to medium oral defects, offering the advantage of inconspicuous donor site closure.
• This technique presents a valuable option to reduce donor site complications compared to traditional methods.