Article
Medial Sural Artery Perforator Flap for Hand
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Published: | October 10, 2017 |
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Outline
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Objectives: In general, complex hand trauma is a catastrophe with both skin loss and multiple tendon and nerve defect, which remains a great challenge to the hand and plastic surgeons. An ideal donor site can not only provide a fasciocutaneous coverage, but also can serve as a source for tendon and nerve graft.
Method: From Sep 2010 to Dec 2016, 22 male patients suffering hand defects were reconstructed with medial sural artery perforator flaps (MSAP). The mean age of the patients was 31 years, and the size of the flaps ranged from 5x3 cm to 14x7 cm. A segment of planaris tendon and/or sural nerve was harvested as the graft to bridge the tendon or nerve defects in 9 patients. The donor sites were closed primarily (15 cases) or with a split thickness skin graft (7 cases). MSAP is also described in terms of its surgical anatomy and elevation technique.
Results: All the flaps survived except one case. All Patients were satisfied with the aesthetic and functional outcome of the reconstructed hand. Donor site morbidity was minimal and no complaints was found.
Conclusion: MSAP flap is a good candidate for hand coverage and it offers a versatile donor site for the simultaneous reconstruction of tendon and nerve in the hand without low donor site morbidity.