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An Intraoperative Study of Flap Thickness Between Medial Sural Artery, Anterolateral Thigh, and Radial Forearm Flaps
Ansarul Haq1, Veena K Singh1, Shreosi Sarkar1
1From the Department of Burns and Plastic Surgery, AIIMS Patna, Patna, India.
Background:
The medial sural artery perforator (MSAP) flap has gained popularity in recent times because of its various advantages over the anterolateral thigh (ALT) and radial artery forearm (RAF) flaps. However, there is a lack of literature comparing the thickness of these flaps between sonographic and intraoperative measurements. This study aimed to compare the thickness of these flaps and to identify the predictors of flap thickness that will help in reconstructive planning.
Methods:
A total of 120 patients underwent reconstructive flap surgery using the 3 flaps (ALT, MSAP, and RAF). The thickness of these flaps was measured by ultrasonography and intraoperative flap measurements. Forward stepwise regressions were conducted to determine the factors contributing to flap thickness.
Results:
The mean age of the patients was 38.4 ± 12.2 years, and the mean body mass index was 23.5 ± 3.3 kg/m2. The mean thickness of the MSAP was 8.3 ± 1.4 mm, whereas it was 17.6 ± 2.9 mm for the ALT and 5.4 ± 1.3 mm for the RAF. All 3 flaps showed significant differences in thickness (P < 0.05). The ALT flap had a positive correlation with female gender and body mass index. No significance was found between the measurement of flap thickness by sonography and intraoperative measurement. (P > 0.05).
Conclusions:
The MSAP flap can be used as a replacement for the RAF or ALT flap in almost all areas if the flap dimensions and pedicle length are fulfilled. Sonographic measurements of flap thickness are a good predictive marker of intraoperative flap thickness.
