title: Early experience with the medial sural artery perforator flap as an alternative to the radial forearm flap for reconstruction in the head and neck.
abstract: The medial sural artery perforator (MSAP) flap has been well-described but has yet to find popularity in the United Kingdom. We describe our early experience of its use in 6 patients and our simplified method of marking up. Flaps ranged in size from 7×4cm to 12×5.5cm, and were thin (between 4 and 10mm). Pedicles were between 11 and 14cm long, arterial diameters were 1-2mm, and venous calibres were 2-6mm. We raised 4 flaps without the use of a tourniquet and found it helpful. Straightening the leg as the popliteal fossa was approached also eased dissection. There can be 2 separate pedicles. The donor site was closed primarily in 5 cases and all flaps survived. The MSAP is easier to do than the radial artery forearm free flap (RAFFF) and is a reliable alternative with low morbidity.
authors.affiliation: Dept Oral and Maxillofacial Sugery, Sunderland Royal Hospital, Kayll Rd, Sunderland SR4 7TP, United Kingdom. Electronic address: michaelnuge@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Nugent
authors.affiliation: Dept Oral and Maxillofacial Sugery, Sunderland Royal Hospital, Kayll Rd, Sunderland SR4 7TP, United Kingdom. Electronic address: simon.endersby@chsft.nhs.uk.
authors.forename: S
authors.initials: S
authors.lastname: Endersby
authors.affiliation: Dept Oral and Maxillofacial Sugery, Sunderland Royal Hospital, Kayll Rd, Sunderland SR4 7TP, United Kingdom. Electronic address: matthew.kennedy@me.com.
authors.forename: M
authors.initials: M
authors.lastname: Kennedy
authors.affiliation: Dept Oral and Maxillofacial Sugery, Sunderland Royal Hospital, Kayll Rd, Sunderland SR4 7TP, United Kingdom. Electronic address: Andrew.burns@chsft.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Burns
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D005542:Forearm / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D011884:Radius / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation*; D016909:Tibial Arteries / Q000637:transplantation*; D014062:Tongue Neoplasms / Q000601:surgery; D060053:Transplant Donor Site / Q000601:surgery
keywords: Head and neck reconstruction; Medial sural artery perforator flap; Perforator flaps