Skin Island Flaps Supplied by the Vascular Axis of the Sensitive Superficial Nerves

TLDR

An anatomical study of 64 fresh legs showed that the vascular axis following superficial sensory nerves supplies skin. The authors examined the saphenous, superficial peroneal, and sural nerves to map this vascular axis. The vascular axis—an artery or interlacing network—provides cutaneous branches, anastomoses with septocutaneous arteries, and turns superficial nerves into vascular relays, enabling a neuroskin island flap that was successfully used in six knee and lower‑limb cases.

Abstract

An anatomic study performed on 64 fresh injected legs has shown the role of the vascular axis that follows the superficial sensitive nerves in supplying the skin. Three nerves were studied: the saphenous nerve, the superficial peroneal nerve, and the sural nerve. Conclusions are the same for the three nerves: The vascular axis, which can be either a true artery or an interlacing network, ensures the vascularization of the nerves, gives off several cutaneous branches in the suprafascial course of the nerve, and anastomoses with the septocutaneous arteries issuing from a deep main vessel. The superficial nerves that course the leg can therefore be considered as vascular relays owing to their neurocutaneous arteries. The concept of a neuroskin island flap has been developed and applied to six clinical cases for coverage of some specific areas of the knee and of the lower part of the limb.