Medial sural artery perforator free flap for the reconstruction of leg, foot and ankle defect: an excellent option

Abstract

MSAP free flap is a reliable choice for leg, foot and ankle defect reconstruction.

Medial Sural Perforator “Nerve through Flap”: Anatomical Study and Clinical Application

“…Soft tissue reconstruction can be performed in many ways but the risk to create a bulky hand is high if the flaps used are not extremely thin. Radial forearm flaps, anterolateral thigh flaps, superficial circumflex iliac perforator flaps or MSAP flaps are examples of widely used thin flaps [3][4][5]. MSAP flap was first described in 2001 by Cavadas and Hallok for both extremity and head and neck reconstructions [17,18] and now are widely used with many variations [18,19].…”

“…Hand skin is thick and specialized on the palmar surface and very thin dorsally. Soft tissue reconstruction can be performed in many ways, but can be very thick (more often than not unless thinned) as with an anterolateral thigh flap, or with other thinner flaps as radial forearm, superficial circumflex iliac perforator or medial sural artery perforator (MSAP) flap [1][2][3][4][5].…”

Medial sural artery perforator flap in reconstruction of soft tissue defect in upper and lower extremities: a clinical study

“…Cavadas et al [2] described that the total number of perforators was between 1 and 4 with a mean of 2.2 and in most patients, there were 2 perforators at a mean of 11.8 cm and 17 cm from the popliteal crease. Balan et al [13] described that the mean flap size was 14.29 × 6.6 cm and the mean pedicle length was 9.71 cm.…”

“…The results of flap success in other studies were: Kao et al [10] had one failed case from 29 patients, Agrawal et al [14] worked on 10 patients with one failed case, Toyserkani et al [8] had worked on 10 patients with 6 uncomplicated cases, 2 total flap losses due to venous congestion, one case had a venous problem that was salvaged and one the flap was changed intraoperative, Chen et al [9] worked on 11 patients with one flap failed, Shun et al [15,16] worked on 31 patients with one flap failed due to pressure on the pedicle and Balan et al [13] worked on seven patients with one flap has a partial loss.…”

“…Toyserkani et al [8] had no donor site complications. Balan et al [13] had 2 donor sites' morbidity in the form of wound dehiscence.…”