title: The medial sural artery perforator flap in intra-oral reconstruction: A Northeast experience.
abstract: BACKGROUND
  The medial sural artery perforator (MSAP) flap is a fasciocutaneous flap that is gaining popularity for intra-oral reconstructions. The aim of this two-centre review was to evaluate the use of the MSAP flap in intra-oral reconstructions and report our experiences.
  
  
  METHODS
  Data were collected prospectively on 35 consecutive intra-oral reconstructions using the free MSAP flap. Patient details and intraoperative flap details were recorded.
  
  
  RESULTS
  Thirty-five patients underwent intra-oral reconstruction with a free MSAP flap (26 males and nine females). The average flap dimensions were a length of 8.03 cm, a width of 5.0 cm and a thickness of 7.1 mm. Twenty-two flaps had two perforators, and the average pedicle length was 11.1 cm. There were no flap losses. Ninety-one per cent of donor sites were closed primarily. There were two minor complications related to donor-site wound dehiscence, which required delayed skin grafting. The overall complication rate was 5.7%.
  
  
  CONCLUSIONS
  The MSAP flap is a good choice for intra-oral reconstruction. It has reliable anatomy and provides thin, pliable skin with a long pedicle. In addition, donor morbidity is low as the donor site can be closed directly in most cases. It is currently our flap of choice for small intra-oral soft tissue defects.
authors.affiliation: Department of Plastic & Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK. Electronic address: rlchalmers@doctors.org.uk.
authors.forename: R L
authors.initials: RL
authors.lastname: Chalmers
authors.affiliation: Department of Plastic & Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: K M A
authors.initials: KM
authors.lastname: Rahman
authors.affiliation: Department of Plastic & Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: S
authors.initials: S
authors.lastname: Young
authors.affiliation: Department of Maxillofacial Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: M
authors.initials: M
authors.lastname: Kennedy
authors.affiliation: Department of Maxillofacial Surgery, Sunderland Royal Hospital, Sunderland, UK.
authors.forename: S
authors.initials: S
authors.lastname: Endersby
authors.affiliation: Department of Maxillofacial Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Adams
authors.affiliation: Department of Plastic & Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: O A
authors.initials: OA
authors.lastname: Ahmed
authors.affiliation: Department of Maxillofacial Surgery, Sunderland Royal Hospital, Sunderland, UK.
authors.forename: M
authors.initials: M
authors.lastname: Nugent
authors.affiliation: Department of Plastic & Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ragbir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D018482:Muscle, Skeletal / Q000098:blood supply; D019647:Oral Surgical Procedures / Q000379:methods*; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D010781:Photography; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods
keywords: Free flap; Intra-oral reconstruction; Medial sural artery perforator flap; Microsurgery