Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan-Jun;8(1):61-65.
doi: 10.4103/ams.ams_137_17.

Medial Sural Artery Perforator Flap for Head and Neck Reconstruction

Affiliations

Medial Sural Artery Perforator Flap for Head and Neck Reconstruction

Gunjan Agrawal et al. Ann Maxillofac Surg. 2018 Jan-Jun.

Abstract

Aim: The aim is to study the assessment of feasibility of medial sural artery perforator (MSAP) free flap for head and neck reconstruction at our center.

Materials and methods: Oral cancer patients with squamous cell carcinoma of the tongue, buccal mucosa, and floor of mouth cancer attending our center were reconstructed using MSAP flap after oncologic resection. Handheld 8 MHz Doppler was used to identify the perforator preoperatively.

Results: We reconstructed 10 patients using MSAP flap. The flap was designed according to defect and donor site was primarily closed in all cases. Excellent results were seen in nine patients reconstructed with MSAP flap without any postoperative complication. Flap failure occurred in one patient due to venous thrombosis. The thickness of flap ranged from 4 to 8 mm. The vascular pedicle length ranged from 9 to 13 cm.

Conclusion: The MSAP flap is appropriate for medium-sized oral defect reconstruction, with a long pedicle of matching caliber, adequate tissue volume, and minimal donor-site morbidity which makes it comparable to other microvascular free flaps such as radial artery free flap (RAFF) and anterolateral thigh flap.

Keywords: Free flap; head and neck reconstruction; medial sural artery perforator flap; perforator flap.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Marking of flap (patient 1)
Figure 2
Figure 2
Flap harvest (patient 2)
Figure 3
Figure 3
Flap harvest (patient 1)
Figure 4
Figure 4
Flap insertion (patient 2)
Figure 5
Figure 5
Prick test (patient 1)
Figure 6
Figure 6
Prick test (patient 2)
Figure 7
Figure 7
Postoperative 6 months of medial sural artery perforator flap
Figure 8
Figure 8
Postoperative 6 months (patient 2)

References

    1. Cavadas PC, Sanz-Giménez-Rico JR, Gutierrez-de la Cámara A, Navarro-Monzonís A, Soler-Nomdedeu S, Martínez-Soriano F, et al. The medial sural artery perforator free flap. Plast Reconstr Surg. 2001;108:1609–15. - PubMed
    1. Kao HK, Chang KP, Chen YA, Wei FC, Cheng MH. Anatomical basis and versatile application of the free medial sural artery perforator flap for head and neck reconstruction. Plast Reconstr Surg. 2010;125:1135–45. - PubMed
    1. Hallock GG. Anatomic basis of the gastrocnemius perforator-based flap. Ann Plast Surg. 2001;47:517–22. - PubMed
    1. Okamoto H, Sekiya I, Mizutani J, Otsuka T. Anatomical basis of the medial sural artery perforator flap in Asians. Scand J Plast Reconstr Surg Hand Surg. 2007;41:125–9. - PubMed
    1. Nugent M, Endersby S, Kennedy M, Burns A. Early experience with the medial sural artery perforator flap as an alternative to the radial forearm flap for reconstruction in the head and neck. Br J Oral Maxillofac Surg. 2015;53:461–3. - PubMed