Perforator pedicled sural neurocutaneous vascular flap: a modeling study in the rabbit

An animal model of a distal pedicled sural neurocutaneous flap for experimental research has not previously been established. The purpose of this study was to construct a sural neurocutaneous vascular flap model in the rabbit.

Thirty-five New England rabbits were divided into four groups. Five rabbits in Group A were used for an anatomical study. Red latex and gelatin-lead oxide were injected into posterior tibial arteries of five rabbits in Groups B and C, respectively. In Group D, 40 neurocutaneous flaps with a single perforator pedicle were raised bilaterally in twenty rabbits. In the right legs, 20 flaps were raised by the normal procedure. In the left legs, the perforator pedicles of 20 flaps were ligated as controls.

The sural nerve originated from the posterior tibial nerve. Its accompanying artery originated from the deep femoral artery and ran to the lateral malleolus following the sural nerve. A perforator of the posterior tibial artery at the superior calcaneus originated from the midpoint of the connecting line between the medial malleolus and calcaneus, and was 0.46 ± 0.03 mm in diameter at its origin. The survival rate of the flaps in the right leg 10 days after operation was 64.7 ± 8.7%. Flaps on the left side underwent total necrosis.

The distal single perforator-based sural neurocutaneous vascular flap in the rabbit presents with anatomical stability, is easy to harvest, and has a reliable arterial supply. The developed method represents a useful animal model for the study of single perforator-based neurocutaneous vascular flaps.