Free adductor perforator flap in lower leg reconstruction

Abstract

We report two cases using the free adductor perforator flap in the reconstruction of defects resulting from tumour ablations in the lower leg. One of the two flaps was nourished by a perforating artery, piercing the adductor magnus muscle and the descending branch of the inferior gluteal artery. The other was supplied merely by a perforating artery through the adductor magnus muscle. In both cases, the lesions were in the posterior side of the body on the lower leg, so we did not need to change the patient's position during the surgery. The surgery could be done in the same operating field. The donor site has minimal morbidity after the harvesting of the flap. The lengths of the perforating pedicles were 5cm. By including the posterior cutaneous nerve of the thigh in the flap, the flap could be used as a sensory flap. The disadvantage of this flap is that the vessels of the pedicle are relatively small, especially, in comitantes veins.