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  • 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.
    Author: Nugent M, Endersby S, Kennedy M, Burns A.
    Journal: Br J Oral Maxillofac Surg; 2015 May; 53(5):461-3. PubMed ID: 25818494.
    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.
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