• Zhaobiao Luo, Guohua Lv, Jianwei Wei, Jiangdong Ni, Lihong Liu, Ping Peng, and Zhonggen Dong.
• Department of Orthopaedics Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China. Electronic address: doctorlzb@csu.edu.cn.
• Burns. 2020 Feb 1; 46 (1): 225-233.

BackgroundDistally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps and distally based posterior tibial artery perforator-plus fasciocutaneous (DPTAPF) flaps are widely used to reconstruct soft-tissue defects of the distal lower leg, ankle, and foot. However, a comparative study of both flaps in a considerable sample size is lacking. This retrospective study aimed to compare the efficacy of the flaps and provide referential evidence for selection of flaps.MethodsBetween April 2001 and October 2016, 227 patients underwent reconstruction with DPAPF flaps (peroneal group; n = 150) or DPTAPF flaps (posterior tibial group; n = 82). The distal lower leg, ankle, and foot were divided into Zones I and II. Flap viability-related complications and their risk factors, reconstruction outcomes, and donor-site morbidities were compared.ResultsIn Zone I, the partial necrosis rate was lower in the peroneal group than in the posterior tibial group (p > 0.05). In Zone II, the partial necrosis rate was significantly lower in the peroneal group (p < 0.05). Significantly lower incidences of donor-site morbidities in terms of hypertrophic scarring, itching, and pigmentation were observed in the peroneal group (p < 0.05).ConclusionsThe DPAPF flap was superior to the DPTAPF flap with respect to reliability and decreased donor-site morbidities. The former is the recommended preferential choice between the two.Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.

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