Applied anatomic study and clinical application of medial sural artery perforator flap

doi:10.19438/j.cjoms.2018.06.005

Abstract

Abstract: PURPOSES: To provide anatomic evidence for clinical application of medial sural artery perforator flaps (MSAP), this study compared the contour and function of donor site and recipient site pre- and post-operatively in order to investigate the clinical value in reconstruction of oral and maxillofacial defects. METHODS: Six lower limbs of Chinese adult cadavers were micro-surgically dissected and the number of perforators was recorded based on medial sural artery perforator flaps, the external diameters, pedicle lengths, and locations were measured. Sixteen clinical cases using medial sural artery perforator flaps for reconstruction were selected from May 2011 to May 2014, the flap size ranged from 3 cm×4 cm to 6 cm×8 cm. The patients were evaluated at 3, 6 and 12 months postoperatively including flap survival number, contour and function of recipient and donor site, and their swallowing and speech function after reconstruction of the tongue and/or floor of mouth. RESULTS: Totally 14 medial sural artery perforators (each leg had 2.3 on average) were found in 6 legs. The average longitudinal distance from the medial sural artery perforators to popliteal crease was (9.15 ±4.05) cm, and (2.82±0.91)cm to posterior midline of the leg. The external diameter of vessel pedicle was (2.11±0.17) mm, and the pedicle length was (12.61±3.15) cm. Among the 16 medial sural artery perforator flaps, two flap had venous crisis and eventually developed necrosis, two patients were lost to follow up. All the cases were followed up for 10-47 months (mean 24 months), two cases with flap necrosis were excluded. Medial sural artery perforator flap was favorable in donor site morbidity, swallowing and speech function. CONCLUSIONS: Medial sural artery perforator flap has a good anatomic stability, with vascular pedicle length and diameter completely meeting requirements of the clinic, which is an ideal choice to reconstruct small or medium-sized oral and maxillofacial defects.

Key words: Perforator flap, Applied anatomy, Medial sural artery perforator flap

CLC Number:

R782.2

SUN Qiuwangyue, GAO Peng-fei, WANG Chen-xing, SONG Xiao-meng, DING Xu, LI Huai-qi, WU He-ming, WU Yu-nong, YUAN Ye, YE Jin-hai, LI Zhong-lian. Applied anatomic study and clinical application of medial sural artery perforator flap[J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(6): 505-510.

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