A Seoul National University Hospital research team has developed a method to minimize the damage to the calf nerve through the cadaveric study of “sural nerve splitting in reverse sural artery perforator flap.”

The study, led by Professors Jang Hak_장학 and Kim Byung-joon_김병준, was selected as the cover for the November’s issue of the Journal of the American Society of Plastic Surgeons, the hospital said Friday. The current issue on the cover is “Sural nerve splitting in reverse sural artery perforator flap: the Anatomical study in 40 cadaver legs.”

The sural artery perforator flap is to remove the thick skin of the calf tissue containing blood vessels, and implanted in the affected area. It is used mainly for reconstruction when there is damage to the distal end of the leg. It is relatively simple, does not take much time, and is widely used in hard-to-implant areas.

The cadaveric study of sural nerve splitting in reverse sural artery perforator flap is on the main cover for the November’s issue of the Journal of the American Society of Plastic Surgeons.

The implanted flap (skin tissue) includes the calf artery of the epidermis. Since the calf nerve is located along the artery, however, there is a higher risk of nerve damage during removal of the implanted flap. This can cause sensory disturbances in the soles of the soles of the calf nerves or some areas of the foot.

First, the team classified the calf nerve developments that occur when flapping is applied to 20 corpses’ lower legs. In 72.5 percent of the cases, when the flap was removed, the inner and outer nerves of the calf were combined and failed to function. The researchers conducted a "neurosurgical procedure" on this specimen where two nerves were connected.

As a result, the team confirmed that the two nerves could be adequately divided without damage to the calf bundle. The area where the inner and outer nerves of the calf were merged was 13.6 centimeters above the external radiating bone. Considering that the main blood vessels of the non-aortic artery flap are located 4 to 7 cm above the radiating bone, the researchers said they could minimize the calf nerve damage by performing a "neurosurgical procedure" in the vicinity of 6.6 to 9.6 cm.

"This research involves graft in existing surgical procedures, and we hope that we will be actively engaged in future medicine by minimizing sensory loss,” Professor Jang said. "I am honored to be selected as a cover paper by the International Society of Plastic and Reconstructive Surgery (PRS).”

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