Island Medial Plantar Artery Perforator Flap for Reconstruction of Plantar Defects

Abstract

Three cases in which island medial plantar artery perforator flaps were successfully transferred for coverage of the plantar defects are described. This perforator flap is different from the medial plantar flap based on the medial plantar artery. The flap has no fascial component and is nourished only with the perforator of the medial plantar vessel. Therefore, transection of the medial plantar artery is usually unnecessary. This flap can cover defects on the forefoot and heel without transaction of the medial plantar system. The advantages of this flap are no need for deep or long dissection for the medial plantar vessel, no exposure of the plantar sensory nerve, a short time for flap elevation, minimal donor-site morbidity, relatively large flap survival, and no damage of both the posterior tibial and medial plantar neurovascular systems.

Free medial plantar artery perforator flap for finger pulp reconstruction: Report of a series of 10 cases

“…Thus, given the unique characteristics of the finger pulp, the medial plantar area is the preferred donor site. Although the free MPAP technique has been reported and presented in the related literature, [14][15][16] no serial study has examined the use of this flap in finger pulp reconstruction. The purpose of this report is to present the our results with using the medial plantar artery perforator flap for reconstruction of composite finger pulp defects and restoration of fingertip sensation after traumatic injury.…”

Free Medial Plantar Artery Perforator Flaps for the Resurfacing of Thumb Defects

“…Although the concept of free tissue transfer to traumatized digits remains unpopular with many surgeons, a free flap of appropriate size may provide an ideal surgical solution to these difficult cases. The medial plantar artery perforator (MPAP) flap, which has been originally described by Koshima et al, 9 is a useful and reliable free flap with low donor site morbidity, although many other small free flaps have been declared to result in equally good donor site healing. 3,10,11 Similar applications, such as the medialis pedis flap and the instep flap, have been described by Chen et al 11 The medialis pedis flap, which can be used as a free flap to cover the volar side of the finger, originates from the terrain of the medial branch of the deep branch of the medial plantar artery.…”

Anatomic basis and clinical application of the distally based medialis pedis flaps

“…The medial plantar island flap requires sacrificing a main vessel and partial disruption of the plantar aponeurosis, which protects the foot from shearing stress [5,49]. Although the modified medial plantar perforator flap does not require sacrificing a main vessel, the venous outflow insufficiency and tedious dissection are constant concerns to surgeons [12,23]. More often than not, the local muscle flaps can cause functional impairment to the foot [24,26].…”

“…Ample reports, either in anatomy or in clinical application, exist in the literature about using pedicled transferred flaps from the leg, dorsal foot, and medial plantar foot for reconstruction of soft-tissue defects of the foot [23,30,41].…”