Descripción anatómica de la irrigación del colgajo sural a pedículo distal en piezas cadavéricas

background: the distally based sural fasciomyocutaneous flap is widely used in the coverage of deep soft tissue defects on the distal third of lower limbs. aim: to perform a morphometric description of the perforating arteries that supplies the flap. material and methods: we used eight lower limbs from amputations performed above the knee. the limbs were injected through the popliteal artery with red colored latex. after the injection, the limbs were dissected to obtain a distally based sural fasciomyocutaneous flap. once the fasciomyocutaneous island was obtained, the flap was elevated dissecting its pedicle. once the whole flap was dissected, a morphometric registry of the lateral and medial perforating arteries was performed. the pivot point for the flap was set 5 cm above the upper border of the lateral malleolus. the distance between the upper border of the lateral malleolus and the emergence of each perforating artery was measured. results: the sural nerve was identified in all eight dissections. a perineural plexus was the source of the blood supply of the flap, in three of the eight dissections. in two dissections, three sural arteries were identified (medial, median and lateral). the lateral sural artery was identified in two dissections and the medial and lateral arteries in one. three to six perforating arteries were identified in the medial part of the pedicle and four to five perforating arteries in the lateral part of the pedicle. conclusions: the distribution of the sural artery along the flap's pedicle is very variable. the most common distribution in these dissections was in the form of a perineural plexus. considering the distance from the lateral malleolus to the emergence of the perforating arteries, the pivot point of the flap, should be set approximately at 5.5 centimeters above the lateral malleolus.