The Anatomy and Clinic ApplicatiThe Anatomy and Clinic Application of Free Medial Sural Artery Peon of Free Medial Sural Artery Pe

rforator Flaprforator Flap

 Xin Wang M.D,  Jianwu Qi M.D Ningbo 6th Hospital, P.R.China 8 June 2013

Challenging job Free medial sural artery perforator flap is very suita

ble 21 clinic cases in our department

Cavadas :(Plast. Reconstr. Surg. 108:1609-1615, 2001)

Geoffrey G. Hallock: (Annals of Plastic Surgery 52:184-187 2004)

Shao-liang chen: (Trauma 58:323-327, 2005)

Hyo Heon Kim:(Plastic and Reconstructive Surgery 117:1609-1618 ,2006)

6 cadaveric specimens at least one substantive perforator Proximal perforator location:

6~12 cm from popliteal crease

About 4 cm from posterior midline of the leg

April 2007 ~ Septemper 2010 21 patients , 16 men , 5 womenAge : 16 to 51 yearsRecipient site :14 hands , and 7 feet.Pay attention to the proximal major perforat

or

Enormous function of the Doppler ultrasound.

skin

Subcutaneous Tissue

Deep Fascia

Muscular Tissue

Supine or prone positionExsanguination and tourniquet control.preserve a superficial vein of the flap. Detach the flap beneath the deep fascia.

Superficial vein Perforator Secondary branch of the medial sural artery

Intramuscular retrograde dissectionAdequate pedicle length and suitable

caliber of artery.the superficial vein Donor site closed directly or covered

with skin graft.

20 flaps surviving,1 flap partial necrosisflap size :7.0×4.5cm to 12×8 cm.17 flaps with single perforator , 4 flaps w

ith 2 perforators.superficial vein of 16 flaps were anastom

osed

Little damage to donor site Suitable for shallow defects A long vessel pedicle Can reconstruct sensation

Thank you !Thank you !