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Suwanprinya C, Luvira V, Winaikosol K, Surakunprapha P, Punyavong P, Jenwitheesuk K, Pugkhem A, Pairojkul C. En bloc groin node resection reconstructed with external oblique flap for solitary metastatic cholangiocarcinoma: a case report. Clin J Gastroenterol 2024:10.1007/s12328-024-01943-w. [PMID: 38517592 DOI: 10.1007/s12328-024-01943-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/24/2024] [Indexed: 03/24/2024]
Abstract
Cholangiocarcinoma requires complete surgical resection for cure. Even so, the recurrence and metastasis rates are high, and further treatment is typically through palliative systemic chemotherapy. Curative-intent resection of metastatic site may provide survival benefit in selected cases. However, there were no previous reports of groin node dissection in cholangiocarcinoma. We have reported the first case of intrahepatic mass-forming cholangiocarcinoma with isolated synchronous groin node metastasis, successfully treated with resection of the liver mass followed by groin node resection, reconstructed with musculofascial flap. A 73-year-old man presented with right upper quadrant abdominal pain radiating to the right groin for two months. Magnetic resonance cholangiopancreatography revealed a 3.1 × 1.2 cm enhancing mass between hepatic segment 4 and the anterior peritoneum, invading the abdominal wall. Computed tomography of the abdomen revealed a 2.4 × 2.2 cm focal enhancing mass at the anterior aspect of the right lower abdominal wall, just anterior to the right inguinal ligament and iliac vessel. He underwent en bloc resection of hepatic segment 4, gallbladder, and anterior abdominal wall, and the histology result is cholangiocarcinoma. After systemic chemotherapy, he underwent en bloc resection of the right groin mass, reconstructed with external oblique musculofascial flap. The patient was able to achieve a 20-month recurrence free survival after the final operation. This case has demonstrated that in a carefully selected case, resection of distant metastasis cholangiocarcinoma can provide survival benefits, even in the rare site of metastasis.
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Affiliation(s)
- Chalisa Suwanprinya
- General Surgery Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | - Vor Luvira
- General Surgery Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kengkart Winaikosol
- Plastic & Reconstructive Surgery Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Palakorn Surakunprapha
- Plastic & Reconstructive Surgery Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pattama Punyavong
- Plastic & Reconstructive Surgery Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kamonwan Jenwitheesuk
- Plastic & Reconstructive Surgery Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ake Pugkhem
- General Surgery Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chawalit Pairojkul
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Siriwiroj S, Pisek P, Punyavong P, Jenwitheesuk K, Surakunprapha P, Winaikosol K. The Effect of Presurgical Nasoalveolar Molding on Oronasal Fistula Following Primary Palatoplasty. J Craniofac Surg 2023:00001665-990000000-01227. [PMID: 37983067 DOI: 10.1097/scs.0000000000009872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/09/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVE Presurgical nasoalveolar molding (PNAM) is widely used in cleft care protocol. This study investigated the correlation between PNAM and oronasal fistula after primary palatoplasty. METHODS A case-controlled study of 80 unilateral and bilateral complete cleft palate patients who underwent cleft palate repair were enrolled. Patients were divided into 2 groups: (1) no PNAM use and (2) PNAM use. The incidence of oronasal fistula and postoperative complications were compared between groups. RESULTS Forty patients in each group demonstrated the same baseline characteristics. The PNAM group showed a significantly lower postoperative oronasal fistula rate (15% versus 50%, P=0.003). Palatal cleft width wider than 12.5 mm increases the odds ratio of fistula formation by 1.19-fold (P=0.037), and the PNAM protected against postoperative palatal fistula formation (odds ratio 0.20, P=0.003). CONCLUSION Presurgical nasoalveolar molding can reduce postoperative oronasal fistula in wide-gap Veau type III and IV cleft palate.
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Affiliation(s)
- Singto Siriwiroj
- Plastic & Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University
| | - Poonsak Pisek
- Department of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pattama Punyavong
- Plastic & Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University
| | - Kamonwan Jenwitheesuk
- Plastic & Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University
| | - Palakorn Surakunprapha
- Plastic & Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University
| | - Kengkart Winaikosol
- Plastic & Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University
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Winaikosol K, Punyavong P, Jenwitheesuk K, Surakunprapha P, Mahakkanukrauh A. Radiation ulcer treatment with hyperbaric oxygen therapy and haemoglobin spray: case report and literature review. J Wound Care 2021; 29:452-456. [PMID: 32804038 DOI: 10.12968/jowc.2020.29.8.452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To explore the effectiveness of a combination of hyperbaric oxygen therapy and haemoglobin spray in radiation ulcer treatment. METHOD We reviewed the available literature and present a case report in which radiation ulcer was treated with a combination of hyperbaric oxygen therapy and haemoglobin spray. RESULTS After 30 sessions of hyperbaric oxygen therapy (2.4 ATA; 90 minutes each session) and administration of haemoglobin spray, the wounds showed gradual progress towards healing and a good granulating base was achieved. The wounds were closed after two months using a small split thickness skin graft. CONCLUSION A combination of hyperbaric oxygen therapy and haemoglobin spray was effective as a short course of treatment for radiation ulcers.
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Affiliation(s)
- Kengkart Winaikosol
- Plastic and Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pattama Punyavong
- Plastic and Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kamonwan Jenwitheesuk
- Plastic and Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Palakorn Surakunprapha
- Plastic and Reconstructive Unit, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ajanee Mahakkanukrauh
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Wongkietkachorn A, Surakunprapha P, Jenwitheesuk K, Eua-angkanakul K, Winaikosol K, Punyavong P, Wongkietkachorn N, Wongkietkachorn S, Salyapongse AN. Indocyanine Green Angiography Precise Marking for Indeterminate Burn Excision: A Prospective, Multi-centered, Double-blinded Study. Plast Reconstr Surg Glob Open 2021; 9:e3538. [PMID: 33868880 PMCID: PMC8049159 DOI: 10.1097/gox.0000000000003538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND During burn excision, the clinical judgment whether to excise or not excise the area with indeterminate burn depth is difficult. Indocyanine green angiography (ICGA) has been reported to provide high accuracy in diagnosing indeterminate burns. This study aims to evaluate the complete wound closures in both short-term and long-term outcomes after using ICGA precise marking to guide indeterminate burn excision. METHODS This was a prospective, multi-centered, double-blinded, experimental study. The participants were admitted to the hospital with indeterminate burn wounds. ICGA precise marking was performed. The deep second-degree burn was painted, excised, and subsequently covered with skin grafts and measured on day 5. The superficial burns were measured on day 21. All wounds were followed-up at two months. RESULTS Thirty indeterminate burn sites were included in this study. Using ICGA precise marking, the overall rate of short-term complete wound closure, which combined superficial and deep burns, was found to be as high as 96.7% (29/30). The long-term complete wound closures at two months confirmed the short-term result and yielded 100.0% of complete wound closure. The complete wound closures between the short-term and long-term measurements were not significantly different (P > 0.999). CONCLUSIONS Using ICGA precise marking to guide indeterminate burn excision resulted in an excellent rate of complete wound closure and an insignificant difference between short-term and long-term wound outcomes. ICGA is a competent method to aid decision-making in burn surgery of the indeterminate area.
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Affiliation(s)
- Apinut Wongkietkachorn
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Palakorn Surakunprapha
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kamonwan Jenwitheesuk
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kant Eua-angkanakul
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Khon Kaen Hospital, Khon Kaen, Thailand
| | - Kengkart Winaikosol
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pattama Punyavong
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Supawich Wongkietkachorn
- Department of Surgery, Faculty of Medicine, Princess Naradhiwas University, Naradhiwas, Thailand
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Tankittiwat P, Pisek A, Manosudprasit M, Punyavong P, Manosudprasit A, Phaoseree N, Wangsrimongkol B, Pisek P, Manosudprasit A. Function of Nasoalveolar Molding Devices in Bilateral Complete Cleft Lip and Palate: A 3-Dimensional Maxillary Arch Analysis. Cleft Palate Craniofac J 2021; 58:1389-1397. [PMID: 33657892 DOI: 10.1177/1055665621990184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study aimed to observe and analyze the effects of nasoalveolar molding (NAM) on maxillary arch dimensions in patients with bilateral complete cleft lip and palate (BCLP) using 3-dimensional analyses. DESIGN Retrospective case series. MATERIALS AND METHODS Seventeen infants were treated using modified Khon Kaen University presurgical nasoalveolar molding devices (KKU-NAM). Dental casts were evaluated 3 dimensionally at 3 time points: pretreatment (T1), after using modified KKU-NAM for 2 weeks (T2), and before cheiloplasty (T3). Repeated-measures analysis of variance and Friedman test were used to compare the maxillary arch dimensions between time points. RESULTS Both sides of the cleft width, premaxilla deviation, and premaxilla protrusion had significantly reduced with the use of KKU-NAM. Premaxillary rotation had significantly improved, whereas the arch depth did not change significantly. Premaxilla width, posterior arch width, alveolar length, and height had significantly increased. The anterior arch width, intercanine width, and lateral sulcus width showed no significant changes. The intraclass correlation coefficient used to test the measurements indicated substantial reliability. CONCLUSION The modified KKU-NAM is an effective device for reducing the severity of bilateral cleft deformities, especially in the premaxilla area.
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Affiliation(s)
- Pawinee Tankittiwat
- Faculty of Dentistry, Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Araya Pisek
- Faculty of Dentistry, Division of Dental Public Health, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Montien Manosudprasit
- Faculty of Dentistry, Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pattama Punyavong
- Faculty of Medicine, Plastic and Reconstructive Unit, Department of Surgery, Khon Kaen University, Khon Kaen, Thailand
| | - Amornrut Manosudprasit
- Faculty of Dentistry, Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Natthawee Phaoseree
- Faculty of Dentistry, Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Buddhathida Wangsrimongkol
- Faculty of Dentistry, Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Poonsak Pisek
- Faculty of Dentistry, Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Aggasit Manosudprasit
- Faculty of Dentistry, Division of Orthodontics, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Wongkietkachorn A, Surakunprapha P, Winaikosol K, Eua-Angkanakul K, Wongkietkachorn N, Punyavong P, Jenwitheesuk K, Chowchuen B, Wongkietkachorn S. Quantitative Burn Depth Analysis Using Indocyanine Green Angiography. J Burn Care Res 2020; 40:725. [PMID: 31181142 DOI: 10.1093/jbcr/irz090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Apinut Wongkietkachorn
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Palakorn Surakunprapha
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kengkart Winaikosol
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kant Eua-Angkanakul
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Khon Kaen Hospital, Khon Kaen, Thailand
| | | | - Pattama Punyavong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kamonwan Jenwitheesuk
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Bowornsilp Chowchuen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Chowchuen B, Surakunprapha P, Winaikosol K, Punyavong P, Kiatchoosakun P, Pradubwong S. Birth Prevalence and Risk Factors Associated With CL/P in Thailand. Cleft Palate Craniofac J 2020; 58:557-566. [PMID: 32911976 DOI: 10.1177/1055665620956896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The objectives of this study were to obtain the birth prevalence of cleft lips and/or cleft palates (CL±P) and to identify potential associated risk factors in the population of the Northeast (NE) region of Thailand. METHODS The data were collected from October 1, 2012, to September 30, 2013, for infant deliveries with nonsyndromic CL±P in all hospitals of 4 provinces in the region. Workshops were conducted to establish diagnostic criteria, treatment guidelines, referral systems, data collection, and data reporting. All patients included in this study, including a case (the child born with cleft lip and palate [CLP]) and 2 control cases (2 following children born without CLP in the same hospital), completed a questionnaire regarding demographics, cleft characteristics, and factors of interest such as alcohol intake, smoking, vitamin use, and medication. Unadjusted and adjusted odds ratio were presented for the magnitude of associations between proposed risk factors and CL±P along with 95% CIs. RESULTS The overall birth prevalence of CL±P was 1.93 per 1000 live births. There was a significant difference in percentages of infants with low birth weights (P = .03), family history of CL±P (P = .01) in cases than controls. Mothers who took self-medication or a menstrual regulation supplement were more likely to have the child with CL±P (P = .01 adjusted). CONCLUSIONS The prevalence of CL±P in the NE Thailand was high. Low infant birth weight, family history of CL±P, and the use of self-medication or menstrual regulation herbal supplement was significant factors.
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Affiliation(s)
- Bowornsilp Chowchuen
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, 26684Khon Kaen University, Khon Kaen, Thailand
| | - Palakorn Surakunprapha
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, 26684Khon Kaen University, Khon Kaen, Thailand
| | - Kengkart Winaikosol
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, 26684Khon Kaen University, Khon Kaen, Thailand
| | - Pattama Punyavong
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, 26684Khon Kaen University, Khon Kaen, Thailand
| | - Pakaphan Kiatchoosakun
- Department of Pediatrics, Faculty of Medicine, 26684Khon Kaen University, Khon Kaen, Thailand
| | - Suteera Pradubwong
- Nursing Division, Srinagarind Hospital, Faculty of Medicine, 26684Khon Kaen University, Khon Kaen, Thailand
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Wongkietkachorn A, Surakunprapha P, Jenwitheesuk K, Winaikosol K, Punyavong P, Chowchuen B, Wongkietkachorn N, Wongkietkachorn S. Improvement in interpretation of indocyanine green angiography. J Plast Reconstr Aesthet Surg 2019; 73:608-620. [PMID: 31883625 DOI: 10.1016/j.bjps.2019.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Apinut Wongkietkachorn
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Mae Fah Luang University, Thasud, Chiang Rai, Thailand.
| | - Palakorn Surakunprapha
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Highway, Muang District, Khon Kaen 40002, Thailand
| | - Kamonwan Jenwitheesuk
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Highway, Muang District, Khon Kaen 40002, Thailand
| | - Kengkart Winaikosol
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Highway, Muang District, Khon Kaen 40002, Thailand
| | - Pattama Punyavong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Highway, Muang District, Khon Kaen 40002, Thailand
| | - Bowornsilp Chowchuen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, 123 Mittraparp Highway, Muang District, Khon Kaen 40002, Thailand
| | - Nuttapone Wongkietkachorn
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Q Clinic, Ladprao, Bangkok, Thailand
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Punyavong P, Winaikosol K, Jenwitheesuk K, Surakunprapha P, Chowchuen B. An Anatomical Study of Vascular Supply of the Distally Based Sural Artery Flap: A Cadaveric Study. J Med Assoc Thai 2016; 99 Suppl 5:S182-S186. [PMID: 29906077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE In this study we conducted the vascular anatomy of sural flap to determine the peroneal artery perforator contribution relative to anatomical landmark of tip of lateral malleolus, include the first peroneal artery perforator to identify safely pivot point of the flap. MATERIAL AND METHOD A retrospective study of an anatomical study of Vascular supply of the Distally Based Sural Artery Flap was performed by dissection on 12 fresh adult cadavers legs. We recorded number of the perforator, location of each perforators in relationship to the tip of lateral malleolus and location of first peroneal artery perforator. RESULTS The anatomical of vascular supply of the distally based sural artery flap, anatomical of peroneal artery perforators was identified and measured from anatomical landmark is tip of lateral malleolus. The mean number of perforators was 3.4 (range, two to five), grouped in 5 perforators at the following average locations proximal to the tip of lateral malleolus: first, at 6.3+0.9 cm; second, at 8.5+1 cm; third, at 11.17+1.4 cm; fourth, at 12.7+1.2 cm; and fifth, at 14.6+0.2 cm proximal to the tip of the lateral malleolus. CONCLUSION Complete vascularization of venoneurofasciocutaneous sural flap was accomplished by peroneal perforator, the blood supply of the distally based sural venoneurofasciocutaneous flap can be pivoted at the lowest perforators in the posterolateral region, which are about 5.4 to 7.2 cm proximal to the tip of lateral malleolus.
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