ABSTRACT
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.
KEYWORDS
Vascularized nerve graft - sural nerve - gastrocnemius perforating artery - fasciocutaneous
flap - compound flap
