The osteoseptocutaneous or purely septocutaneous peroneal flap with a supramalleolar skin paddle

There are many indications for using the peroneal flap in maxillofacial reconstructive surgery, either as a cutaneous flap or combined with a fibula segment. According to the results of our anatomic study and clinical experience with 14 patients, the supramalleolar segment is especially suitable as donor region because the highest density of septocutaneous perforating vessels exists here; hence, the preparation of a long vascular pedicle is possible. The donor site leaves an acceptable defect with appropriate patient selection.