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Arch Hand Microsurg > Volume 23(4); 2018 > Article
Archives of Hand and Microsurgery 2018;23(4):290-295.
Published online December 1, 2018.
Survival of Neuro-Venous Flap without Perforator due to Accidental Division of Perforator
Je Yeon Byeon, Hwan Jun Choi
Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Received: 25 July 2018   • Revised: 11 September 2018   • Accepted: 8 October 2018
Author planed peroneal artery perforator flap for ankle reconstruction and experienced successful result using sural neuro-lesser saphenous venous flap due to an unexpected event. A male Asian patient, 24 years old, had a history of recurrent operation wound disruption in the ankle region. Under general anesthesia, peroneal perforator and saphenous vein, as well as the sural nerve branches, were identified and preserved. In the process of flap rotation, an accidental division of peroneal artery perforator has occurred. Despite the division of the perforator, circulation was normal. The patient experienced no complication after the surgery. Some study reported that accompanying arteries and the vascular plexus around the sural nerve communicate. In conclusion, sufficient blood supply was possible only with the accompanying artery of the sural nerve without peroneal perforator. So, it is essential to always preserve not only perforator but also neurovascular bundles at any circumstances and any location.
Key Words: Ankle, Reconstructive surgical procedures, Perforator flap, Wounds and injuries
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