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The super thin external pudendal artery (STEPA) flap
Alex F Phoon1, Amit K Shah2, George C Cormack1
1Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK; UTSW UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA.
Summary
A new super thin external pudendal artery (STEPA) flap offers a promising solution for reconstructive microsurgery. This thin, supple flap provides a viable option for challenging reconstructions with minimal donor site morbidity.
Area of Science:
- Microsurgery
- Plastic Surgery
- Anatomy
Background:
- The
- ideal
- free flap for microsurgical reconstruction remains elusive, particularly for thin and supple tissue requirements.
Purpose of the Study:
- To describe a novel free tissue transfer, the super thin external pudendal artery (STEPA) flap, for reconstructive microsurgery.
- To evaluate the anatomical feasibility and characteristics of the STEPA flap.
Main Methods:
- Anatomical cadaveric study involving six fresh cadavers.
- Raising of hemiscrotal and scrotal flaps based on external pudendal vessels.
- Vascular anatomy evaluation using computed tomographic angiography and latex injection.
Main Results:
- The STEPA flap is the thinnest myocutaneous free flap, with over 80% measuring less than 1.1 mm.
- Demonstrated reliable anatomy with adequate vessel caliber (artery 2.81 mm, vein 4.44 mm).
- Mean pedicle length of 11 cm and favorable donor site morbidity.
Conclusions:
- The STEPA flap is a thin, supple, and reliable option for reconstructive microsurgery.
- Offers a large surface area and generous pedicle length.
- Potential for use in various clinical scenarios requiring thin tissue reconstruction, despite potential cosmetic considerations.
