The Medial Sural Artery Perforator Flap: Lessons Learned from 200 Consecutive Cases

Area of Science:

• Microsurgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• The medial sural artery perforator flap is a valuable tool in reconstructive microsurgery.
• Previous reports on this flap have often been limited by small sample sizes.

Purpose of the Study:

• To review the experience of a single, high-volume center using the medial sural artery perforator flap.
• To evaluate the flap's utility and outcomes for diverse reconstructive needs.

Main Methods:

• A retrospective review was conducted.
• Data from patients undergoing medial sural artery perforator flap reconstruction between March 2006 and July 2014 were analyzed.

Main Results:

• Two hundred medial sural artery perforator flaps were utilized across head and neck, upper extremity, and lower extremity reconstructions.
• The overall flap survival rate was 96%, with flaps used in free and pedicled configurations.
• Variants like chimeric flaps and dual skin paddles were employed, and tendon/nerve grafts were harvested in select cases.

Conclusions:

• The medial sural artery perforator flap is a dependable, versatile workhorse flap for small to medium-sized defects.
• Its ability to be harvested as free or pedicled, along with the incorporation of multiple tissue components, enhances its reconstructive applications.