Gastrocnemius perforating artery flap including vascularized sural nerve.
A degree of communication was found between the superficial sural artery (the concomitant vessel of the sural nerve) and the muscle perforators from the gastrocnemius muscle, together with the cutaneous branches of the peroneal artery. A fasciocutaneous flap designed in the posterior calf region, including the vascularized sural nerve, was elevated based on the perforating artery of the gastrocnemius. This compound flap was used to reconstruct facial nerves and soft-tissue defects created by resection of malignant tumors in three patients. The results were satisfactory, and facial animation returned in two patients, who were followed-up for more than 6 months. This compound flap offers several advantages, such as a long vascular pedicle with a sufficient diameter and a rich blood supply for the sural nerve and fasciocutaneous flap. This new technique should become another choice for vascularized sural nerve grafts, when the superficial sural artery or the cutaneous branches of the peroneal artery are not adequate for flap elevation or microsurgical anastomoses.
Kashiwa
Katsuhiko
K
Department of Plastic and Reconstructive Surgery, Iwate Medical University, Uchimaru, Morioka, Japan.
Kobayashi
Seiichiro
S
Hayashi
Masayasu
M
Honda
Takayuki
T
Nasu
Wakako
W
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply*; D010307:Parotid Neoplasms / Q000601:surgery; D012878:Skin Neoplasms / Q000601:surgery; D013497:Sural Nerve / Q000098:blood supply*; D013524:Surgical Flaps / Q000098:blood supply*