A reversed superficial peroneal neurocutaneous island flap based on the descending branch of the distal peroneal perforator: clinical experiences and modifications

The distally based neurocutaneous flaps have been popular for lower leg and foot reconstruction. On the basis of pre-existing anatomic studies and clinical experiences, we designed a reversed superficial peroneal neurocutaneous island flap with the descending branch of the distal peroneal perforator as the pedicle. The flap is supplied through both axial perforator and longitudinal chain-linked vascular plexuses. This modified neurocutaneous island flap, measuring around 5 cm x 4 cm to 12 cm x 13 cm in size, was transferred for coverage of foot soft-tissue defects in 21 cases with a low complication rate. Compared to the original neurocutaneous flap, the rotation point of this flap is more distal and the pedicle is thinner. It could provide good texture and contour matching to the recipient area. In conclusion, the modified neurocutaneous island flap provides a reliable tool for repairing soft-tissue defects of the ankle and foot.