Popliteal fossa reconstruction with a medial sural artery perforator free flap using the medial sural vessel as the recipient

Kim, Kyu Nam; Kim, Sang Il; Ha, Wansoo; Yoon, Chi Sun

doi:10.1080/2000656x.2017.1279622

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Cavadas et al 6 and Shim et al 8 landmark papers established the reliability of the MSAP flap compared with the gastrocnemius flap. The main contributions of Han et al 9 and Kim et al 10 were the description of a chimeric MSAP-gastrocnemius flap and the application of free MSAP flaps for popliteal reconstruction, respectively. More recently, the largest case series of 17 MSAP flaps used for knee reconstructions was published by Ling et al, 11 almost doubling the number of cases reported in the literature to date.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of the Pedicled Medial Sural Artery Perforator Flap for Soft Tissue Reconstruction Around the Knee: When to Use It and How to Look After It

Narayan

Berner

Saeed

et al. 2022

Journal of Hand and Microsurgery

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Introduction The medial gastrocnemius flap is an established workhorse flap to cover proximal leg defects due to its reliability and simplicity to raise. However, it has the disadvantage of being bulky, requiring a skin graft for coverage, and is associated with loss of muscle power. The pedicled medial sural artery perforator (MSAP) flap has gained popularity as a reconstructive alternative for defects of the lower extremities. We present a case series of pedicled MSAP flaps for reconstructing defects around the knee as an alternative to the medial gastrocnemius flap. Materials and Methods A consecutive series of patients with proximal leg defects following trauma, osteomyelitis, burns, and chronic wounds were included. A hand-held Doppler was used to map out the MSAPs. Defects were reconstructed using pedicled MSAP flaps, preserving the nerve supply to the gastrocnemius muscle. Patient outcomes were recorded, including their Enneking scores postreconstruction. Results A total of 10 pedicled flaps was performed to reconstruct defects around the knee joint between October 2017 and November 2018. All the patients were discharged 1 week postoperatively, and rehabilitation consisted of graduated flexion in a knee brace by means of controlled passive mobilization. Three out of the ten patients developed complications: one patient developed flap congestion, one developed epidermolysis of the tip of the flap, and the other patient had partial necrosis of the skin paddle. The average Enneking score was 29 out of 35. Conclusion The pedicled MSAP flap is a good reconstructive option for proximal leg defects as it is associated with lower donor site morbidity and provides an aesthetically pleasing reconstruction.

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Section: Discussionmentioning

confidence: 99%

Outcomes of the Pedicled Medial Sural Artery Perforator Flap for Soft Tissue Reconstruction Around the Knee: When to Use It and How to Look After It

Narayan

Berner

Saeed

et al. 2022

Journal of Hand and Microsurgery

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“…In case of free flap reconstruction around the knee the surgeon can use its pedicle as a recipient's vessel to avoid deeper dissection and the use of vein graft. It is also a thin flap even in obese patients [4].…”

Section: Introductionmentioning

confidence: 99%

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

Hegazy

Gozlan

Elkafrawi

et al. 2020

Alexandria Journal of Medicine

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Extended Use of Chimeric Medial Sural Artery Perforator Flap for 3-Dimensional Defect Reconstruction

et al. 2019

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Background The medial sural artery perforator (MSAP) flap has become increasingly popular because it is thin and pliable for small to moderate defect soft tissue reconstruction. Furthermore, chimeric MSAP flap, which includes a skin paddle and a separated piece of medial gastrocnemius muscle, allowed more freedom for flap insetting, especially in 3-dimensional defect reconstruction. Here we describe our experience regarding this clinical application. Patients and Methods From 2007 to 2016, 14 male patients (average age, 46.9 ± 14.4 years) who received either a free or pedicled chimeric MSAP flap were included. Of these 14 patients, 7 received this flap for reconstruction in the head and neck, 2 in the upper extremities, and 5 in the lower extremities. Demographic data were collected and analyzed, and a literature review was performed. Results Ten patients received free chimeric MSAP flap, and 4 received the pedicled type. Thirteen of the 14 flaps (92.6%) survived, and 1 failed 2 days later owing to venous insufficiency. Venous congestion-related partial loss occurred in another case. Conclusions The chimeric MSAP flap is a good alternative for deep space obliteration or reconstruction of adjacent but separate defects in both free and pedicled flap design. Donor site morbidity is limited. However, the perforator needs to be mobilized carefully to prevent postoperative venous compromise.

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Popliteal fossa reconstruction with a medial sural artery perforator free flap using the medial sural vessel as the recipient

Abstract: The obvious advantages of this technique included simple vascular anastomosis (minimal size discrepancy), no intraoperative position changes, and good aesthetic outcomes (replacing like with like).

Cited by 3 publications

References 23 publications

Outcomes of the Pedicled Medial Sural Artery Perforator Flap for Soft Tissue Reconstruction Around the Knee: When to Use It and How to Look After It

Outcomes of the Pedicled Medial Sural Artery Perforator Flap for Soft Tissue Reconstruction Around the Knee: When to Use It and How to Look After It

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

Extended Use of Chimeric Medial Sural Artery Perforator Flap for 3-Dimensional Defect Reconstruction

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