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Neurovascular Stalk of the Superficial Sural Flap: Human Fetus Anatomical Study

Background: The neurovascular stalk of the superficial sural flap, which is the most frequently used, is composed of the lesser saphenous vein, the sural nerve, and the median superficial sural artery. However, it has many variations. This is very important for its application in the reconstruction of soft-tissue defects. The aim of the authors’ research was to detect the presence of the superficial sural blood vessels and to investigate their relationships with the sural nerve and the lesser saphenous vein. Methods: The study group consisted of 42 fetal lower extremities. Fetuses were fixed in 10% formalin and their blood vessels were injected with Micropaque solution (barium sulfate). Results: The median superficial sural artery was detected in 83.3 percent of the cases, whereas the sural nerve and lesser saphenous vein were detected in all cases. The median superficial sural artery was located lateral to the medial cutaneous sural nerve and sural nerve, whereas the lesser saphenous vein was located medially. Conclusions: All three superficial sural arteries (medial, median, and lateral) were detected in fetuses with different gestational ages. The median superficial sural artery was the most frequently detected one and had the constant relationship with the other elements of the neurovascular stalk of the superficial sural arteries.