Vascular Anatomy of the Integument of the Lateral Lower Leg: An Anatomical Study Focused on Cutaneous Perforators and Their Clinical Importance

Background: Certain studies have attempted to investigate the vascular anatomy of the integument of the lateral aspect of the lower leg. However, many issues remain controversial. The aim of this study was to investigate in detail the distribution and characteristics of cutaneous perforators of the lateral aspect of the lower leg. Methods: Fifty-two fresh cadaver legs were dissected. The lateral lower leg was divided into five zones, and all cutaneous perforators were identified. Only perforators with a diameter greater than 0.5 mm were dissected further, and the type, location, course, length, and origin of those perforators were recorded. Results: Three hundred two perforators were dissected. Two hundred twelve were septocutaneous (70.2 percent), 43 were septomusculocutaneous (14.2 percent), and 47 were musculocutaneous (15.6 percent). The majority of perforators (78.1 percent) originated from the peroneal artery. The peroneal artery was the dominant source vessel in all except for the proximal zone. The tibial-peroneal trunk predominated in the proximal zone. High contribution of the posterior tibial artery was noticed in the distal zone. Higher percentages of perforators were recorded in the middle and midproximal zones (26.8 percent and 25.2 percent, respectively). Septocutaneous perforators were present in all five zones, with higher percentages in the middle and middistal zones. Septo-musculocutaneous and musculocutaneous perforators were identified in all except for the distal zone. Conclusion: The authors' findings provide information about the cutaneous perforators/perforasomes of the lateral aspect of the lower leg, useful for reliable planning and harvesting of perforator-based flaps in this area. (Plast. Reconstr. Surg. 128: 188, 2011.)