Direct popliteal artery perforator flap： anatomical study and clinical application

Abstract

Objective To investigate and evaluate the clinical effect of the direct popliteal artery perforator flap. Methods Thirty embalmed lower limbs of adult cadavers which perfused with red latex were used to dissection, major observations were the origin, perforators and anastomoses regulations of the direct popliteal artery. Based on the anatomical study, direct popliteal artery perforator flaps were designed and used clinically to 7 patients who had soft tissue defects in popliteal fossa. Results The direct popliteal artery perforator was direct started from lateral wall of the superior segment of popliteal artery, and about 7-11 cm above knee joint. Then it goes up along the middle line of posterior region of thigh, and pierced from the carvity between semitendinosus and biceps femoris and gave off several branches in superficial fascia. Finally, these branches anastomoses with many perforating branches which were gave off form deep femoral artery （the 1 st to 3rd perforator artery） , obturator artery and lateral circumflex femoral artery. Clinically, all flaps were survived eventually, and 6 of them were healed quickly, only 1 case needed to change dressings to healed its partial necrosis for the pedicle had too much soft tissues and too swelling to block its blood supply. After 2-12 months of following-up, the colors and appearances of these flaps were excellent, and the function of knees were nearly normal. Conclusion Direct popliteal artery perforator flap has relatively constant location and sufficient blood supply to use in clinical application, it is safe and easy to use for recovering soft tissue defects in popliteal fossa. Key words: Direct perforator of popliteal artery; Perforate flap; Popliteal fossa; Applied anatomy