To investigate the application effect of digital subtraction angiography in peroneal artery perforator flap transplantation.

The clinical data of 18 patients who underwent peroneal artery perforator flap from January 2020 to December 2022 in Department of Burn and Plastic Surgery, Jinling Hospital, the Affiliated Hospital of Medical School of Nanjing University were analyzed retrospectively. Before operation, digital subtraction angiography (DSA) was performed to determine the course of peroneal artery and the distribution of perforating branches. Then ultrasonic Doppler was used to assist the design of flap based on the wound condition. The flap was harvested and transferred to cover the wound. The donor site was repaired by direct suture or skin graft. The postoperative followed-up was performed in 6-12 months, focusing on the appearance of skin flap, donor site and functional recovery of affected limb.

DSA showed the peroneal artery along with the posterior tibial artery and its perforating branches, which connected with each other to form a vascular network. The flaps and skin graft in donor site survived well. Follow-up showed that the appearance and texture of the flap were good, and the function of the affected limb recovered.

The DSA can clearly show the course and perforating branch of peroneal artery. Combinational use of DSA and ultrasonic doppler in guiding the design and transplantation of skin flap can achieve good results in the repair of wounds in the middle and lower leg, ankle and foot.