Comparative study of reverse flow island flaps in the lower extremities--peroneal, anterior tibial, and posterior tibial island flaps in 25 patients.

The reverse flow island flap is one of the most versatile reconstructive procedures in the lower extremity. There are three major arteries, the peroneal, the anterior tibial, and the posterior tibial artery, and a reverse flow island flap pedicled by each vessel and its intermuscular cutaneous perforators is available. Twenty-five reverse flow island flaps were clinically applied for soft tissue defects in the lower leg (10 peroneal, 8 anterior tibial, and 7 posterior tibial flaps). We report a comparative study of the characteristics and indications of the peroneal, anterior tibial, and posterior tibial reverse flow flaps. We conclude that the anterior tibial reverse flow flaps are more likely, without venous anastomosis, to become congested and necrose than the peroneal and posterior tibial flaps.