title: The lower medial thigh perforator (LMTP) flap for lower extremity reconstruction: Preliminary results.
abstract: BACKGROUND
  The lower medial thigh perforator (LMTP) flap is an alternative source for lower extremity reconstruction. In this article, we report the preliminary results of reconstruction of the lower extremity with a series of patients by the lower medial thigh perforator flap.
  
  
  METHODS
  From January 2015 until August 2015, we performed six cases of lower extremity reconstruction with the LMTP flap. The defect locations included the distal leg (1 case) and the proximal leg (2 cases), the left foot (2 cases), and the right foot (1 case). The perforators of the flap design were detected at the distal third of the line, which was drawn from the midpoint of inguinal ligament to medial upper border of patella. The dorsalis pedis artery (2 cases), anterior tibia artery (2 cases), posterior tibial artery (2 cases) were dissected as recipient vessels.
  
  
  RESULTS
  The average size of flap was 10.5 × 5 cm (range 10-15 cm and 4-6.5 cm), and the average pedicle length was 7.6 cm (range 5-9.5 cm). 83% of the perforators (5 of 6) were musculocutaneous type, and 17% (1 of 6) were septocutaneous type. The flap survival rate was 100%; the venous congestion was observed in one flap and was successfully salvaged by performing revised venous anastomosis. The donor sites were all closed primarily with minimal morbidity. Follow-up observations were conducted for 2-6 months, and all patients had good functional recovery with satisfactory cosmetic results.
  
  
  CONCLUSIONS
  The lower medial thigh perforator flap has some advantage in lower extremity reconstruction, including adequate length and vessel diameter of pedicle for microvascular anastomosis to the lower extremities recipient vessels. The LMTP flap indicates a low donor-site morbidity and it could be a safe, reliable, and aesthetically appealing new option for lower extremity reconstruction. © 2016 Wiley Periodicals, Inc. Microsurgery 36:474-479, 2016.
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.|Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Mario F
authors.initials: MF
authors.lastname: Scaglioni
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Fakin
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Pietro
authors.initials: P
authors.lastname: Giovanoli
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, and Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yur-Ren
authors.initials: YR
authors.lastname: Kuo
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. bow110470@gmail.com.
authors.forename: Pao-Jen
authors.initials: PJ
authors.lastname: Kuo
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D013848:Thigh; D016896:Treatment Outcome