The Medial Sural Artery Perforator Free Flap

Cavadas, Pedro C.; Sanz-Giménez-Rico, Juan R.; Cámara, Arturo Gutierrez-de la; Navarro-Monzonis, A.; Soler-Nomdedeu, Santiago; Martı́nez-Soriano, Francisco

doi:10.1097/00006534-200111000-00028

Cited by 80 publications

(139 citation statements)

References 10 publications

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“…18 The lateral sural artery system and its perforators, which supply the medial gastrocnaemius muscle and the overlaying skin, are much less reliable, being present in only 20% of the dissections. 16 The skin perforator from the medial sural artery is able to supply almost the whole skin overlying the muscle, with an average area of 13 Â 8 cm. 18 Although the abovementioned anatomical studies attempt to provide surgical landmarks for the identification and dissection of perforators, it is our opinion that any single patient should be preoperatively investigated by a Doppler ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Gastrocnaemius-propeller extended miocutanous flap: A new chimaeric flap for soft tissue reconstruction of the knee

Innocenti

Cardin-Langlois

Menichini

et al. 2014

Journal of Plastic, Reconstructive & Aesthetic Surgery

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KEYWORDSLower limb reconstruction; Propeller flap; Soft tissue loss around the knee Summary Purpose: Soft tissue defects involving the anterior aspect of the knee are a frequent finding in a number of pathological conditions. The aim of this article is to describe a new pedicled flap consisting of a conventional medial gastrocnaemius muscle flap associated with a propeller flap based on a perforator of the medial sural artery. Material and methods: Five males ranging in age between 26 and 72 years underwent a reconstruction of the soft tissue of the knee by means of the described procedure. Three patients sustained complex tissue loss subsequent to high-energy trauma; two losses were due to septic complications after elective knee surgery. Results: Four flaps survived allowing adequate proximal tibial metaphysis and patella coverage. One patient underwent early above-the-knee amputation due to life-threatening septicaemia. Discussion: The described chimaera flap consists of a medial gastrocnaemius flap with a skin paddle that is elevated on a perforator of the medial sural artery and then rotated according to the propeller flaps' principles. It provides effective coverage of large soft tissue defects of the knee. In the authors' experience, the propeller flap portion proved to be particularly useful to cover the patella, while the muscle flap was used to cover the proximal metaphysis of the tibia and fill the dead space if present.

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Section: Discussionmentioning

confidence: 99%

Gastrocnaemius-propeller extended miocutanous flap: A new chimaeric flap for soft tissue reconstruction of the knee

Innocenti

Cardin-Langlois

Menichini

et al. 2014

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Cavadas [3] first described the medial sural artery perforator free flap and provided precise topography of perforating vessels from the medial and lateral gastrocnemius muscle. Others have described the anatomy of the perforating vessels that supply the fascia and skin of the posterior calf in more detail [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…This ensured maximum length for rotation. Cavadas [3] described the raising of the flap using a tourniquet and a non-exsanguinated limb. [13].…”

Section: Discussionmentioning

confidence: 99%

“The Practical Perforator Flap”: the sural artery flap for lower extremity soft tissue reconstruction in wounds of war

Waes

Halm

Vermeulen

et al. 2012

Eur J Orthop Surg Traumatol

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“…Em 2001, Hallock (10) descreveu as bases anatômicas do retalho baseado nas perfurantes do MGM, seguido pelos trabalhos de Cavadas em 2001 (11) e Thione et al em 2004 (12) de dissecção anatômica e injeção de resina nos vasos. Em nosso trabalho, a visualização da anatomia vascular do MGM e de suas artérias perfurantes se deu por dissecção e injeção de contraste radiopaco nos vasos e estudo das imagens radiológicas.…”

Section: Introductionunclassified

“…90% dos casos, foi observado que as perfurantes originaram-se do tronco intramuscular lateral (figura 4). As perfurantes emergiram na fáscia muscular a uma distância média da prega poplítea de 10,4cm, varianFigura 4 -Mamografia da peça mostrando dois troncos intramusculares e as perfurantes (TL = tronco lateral, TM = tronco medial, H = hilo, ASM = artéria sural medial, P = perfurantes) (12) e Cavadas et al (11) , que observaram pelo menos uma perfurante.…”

Section: Introductionunclassified