[Clinical applications of the neurocutaneous axial flap pedicled with perforating vessels].
OBJECTIVE
To report the operative technique and clinical results of the neurocutaneous vascular axial flap with perforating vessels as its pedicle.


METHODS
An axial skin flap was designed along the axis of small paraneural vessels that was close to a concomitant cutaneous nerve. The cutaneous perforating branches of major arteries were used as the pedicle, which provided a rotation arc for the flap to cover the defects in the distal site of extremities. 43 neurocutaneous vascular axial flaps were transferred, including 13 sural neurocutaneous axial flaps (30 cm x 12 cm to 16 cm x 8 cm) supplied by perforating branches of the peroneal vessel; 9 saphenous neurocutaneous axial flaps (15 cm x 8 cm to 5 cm x 4 cm) with posterior tibial perforators as the pedicle; 8 posterior antebrachial neurocutaneous axial flaps (16 cm x 6 cm to 10 cm x 4 cm) based on the dorsal branch of the anterior interossea vessel and 13 reversed neurocutaneous axial flaps (6.0 cm x 3.5 cm to 2.5 cm x 1.5 cm) on the dorsal hand pedicled with the perforators at the interdigital web space.


RESULTS
42 flaps survived completely. One flap underwent venous congestion with necrosis on the distal one fourth of the flap. The color and texture of the flaps were good. The appearance and functional results were satisfactory as revealed by follow-up for 6 to 24 months.


CONCLUSIONS
The modified operation combines the advantages of both the perforator flap and the neurocutaneous axial flap, enlarges the size of the flap and extends the scope of reconstruction. The flap is characterized with delicate designation, easy dissection and reliable blood supply. It is a good method in repairing the skin defects of the extremities.
Department of Orthopaedics, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
Yi-min
YM
Chai
Chong-zheng
CZ
Lin
Xun-yong
XY
Qiu
Han-dong
HD
Chen
Kuai-sheng
KS
Wang
Yan-kun
YK
Chen
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012867:Skin / Q000098:blood supply* / Q000294:innervation*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply* / Q000294:innervation*; D055815:Young Adult