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Reconstruction of distal hand and foot defects with the free proximal peroneal artery perforator flap
Author(s) -
Scaglioni Mario F.,
Kuo YurRen,
Chen YenChou
Publication year - 2016
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.22364
Subject(s) - medicine , peroneal artery , surgery , anastomosis , microsurgery , free flap , perforator flaps , foot (prosody) , dorsum , artery , vein , anatomy , linguistics , philosophy
Background The proximal peroneal artery perforator (PPAP) flap is a reliable, thin fasciocutaneous flap. The purpose of this article was to report our experience with the use of free PPAP flaps for reconstruction of defects of the distal hand and foot. Patients and Methods From November 2012 to September 2013, 9 patients received reconstruction with 10 free PPAP flaps. The defect locations included the big toe (2 cases), metatarsophalangeal joint (5 cases), dorsal finger (2 cases) and volar finger (1 case). Flaps were raised based on proximal peroneal perforator vessels without sacrificing the peroneal artery. The first dorsal metatarsal artery (5 cases) and digital artery (5 cases) were dissected as recipient vessels. Results The flap sizes varied from 2.5 x 2 cm to 9 x 5 cm. All of flaps were survival after surgery. One flap suffered from venous thrombosis and was successfully salvaged by performing a venous thrombectomy and vein graft. The donor sites were all primarily closed with minimal morbidities. Follow‐up observations were conducted for 7 to 20 months, and all patients had good functional recovery with satisfying cosmetic results. Conclusion Perforators arising from the peroneal artery in the proximal lateral leg can be used to design small, pliable fasciocutaneous flaps. Although the pedicle is short, the vessel diameter is adequate for microvascular anastomosis to the distal foot and hand recipient vessels. The free PPAP flap may be a good option for reconstructing distal hand and foot defects. © 2014 Wiley Periodicals, Inc. Microsurgery 36:183–190, 2016.