Background : Popliteo-posterior thigh fasciocutaneous island flap ( PPT flap ), nourished from the direct branches of the popliteal artery for the repair of skin defects around the knee, was reported in 1989. However, there are few reports regarding anatomical information of this branch and PPT flap. Methods : Eight fresh cadaveric lower extremities were dissected following injection of silicon compounds into the femoral artery. We investigated the number, location, and diameter of the direct branches of the popliteal artery, as well as location of cutaneous perforators to the PPT flap. Results : The mean number of direct branches from the popliteal artery was 2.0, with a mean diameter of 0.9 mm and mean pedicle length of 5.2 cm, which were located an average of 4.5 cm proximal to the bicondylar line. At least one branch consistently nourished the PPT flap. All branches passed through the fat of the septal plane between the hamstrings and ran along the posterior femoral cutaneous nerve. The most distal branch was always located at the junction of the small saphenous vein and the popliteal vein. The skin perforators were mostly found in the lower and middle thirds of the posterior thigh. Conclusion : The PPT flap should be included in the posterior femoral cutaneous nerve for good blood supply and this flap can be used as a NAF flap ( neuro-accompanying artery fasciocutaneous flap ).
