Peroneal island flap for skin defects in the lower extremity.

Two types of peroneal island-flap transfer were used in fourteen patients with a large defect in the soft tissues of the lower extremity. The peroneal artery and vein and their cutaneous branches form the pedicle, and an extensive transfer of skin is possible either from above the knee or from the lateral side of the leg to as far distal as the foot. Two methods were used: in the first we severed the peroneal artery and vein distally, with an island of skin attached, and elevated them proximally, and in the second we severed the proximal portions of the peroneal vessels, with an island of skin attached, and elevated them distally. The largest flap that we used in this series measured fourteen by 16.5 centimeters and the smallest, 2.5 by five centimeters. All fourteen transfers healed, with no necrosis of the flap.