An Anatomical Study of Vascular Supply of the Distally Based Sural Artery Flap: A Cadaveric Study
Pattama Punyavong MD*, Kengkart Winaikosol MD*, Kamonwan Jenwitheesuk MD*, Palakorn Surakunprapha MD*, Bowornsilp Chowchuen MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : In this study we conducted the vascular anatomy of sural flap to determine the peroneal artery perforator
contribution relative to anatomical landmark of tip of lateral malleolus, include the first peroneal artery perforator to identify
safely pivot point of the flap.
Material and Method: A retrospective study of an anatomical study of Vascular supply of the Distally Based Sural Artery Flap
was performed by dissection on 12 fresh adult cadavers legs. We recorded number of the perforator, location of each
perforators in relationship to the tip of lateral malleolus and location of first peroneal artery perforator.
Results : The anatomical of vascular supply of the distally based sural artery flap, anatomical of peroneal artery perforators
was identified and measured from anatomical landmark is tip of lateral malleolus. The mean number of perforators was 3.4
(range, two to five), grouped in 5 perforators at the following average locations proximal to the tip of lateral malleolus: first,
at 6.3+0.9 cm; second, at 8.5+1 cm; third, at 11.17+1.4 cm; fourth, at 12.7+1.2 cm; and fifth, at 14.6+0.2 cm proximal to the
tip of the lateral malleolus.
Conclusion : Complete vascularization of venoneurofasciocutaneous sural flap was accomplished by peroneal perforator,
the blood supply of the distally based sural venoneurofasciocutaneous flap can be pivoted at the lowest perforators in the
posterolateral region, which are about 5.4 to 7.2 cm proximal to the tip of lateral malleolus.
Keywords : Sural artery flap, Anatomical study, Peroneal artery perforator, Vascular supply
