The 4th Congress of Asian Pacific Federation of Societies for Reconstructive Microsurgery, Antalya, Turkey, 9 - 13 May 2018, pp.336-337
MEDIAL SURAL ARTERY PERFORATOR FLAP FOR RECONSTRUCTION 1/3 PROXIMAL DEFECT
Emrah Kagan Yasar, Aykut Gök, Yusuf Alper Aytac, Murat Şahin Alagöz
Department of Plastic, Reconstructive and Aesthetic Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey
PURPOSE: In the defects of the proximally tibia 1/3, the pedicled transposition of the gastrocnemius muscles is
the first choice of reconstruction. However, there are disadvantages such as muscle loss and a long donor site scar
tissue. The medial sural artery perforator blade does not have these disadvantages and provides very good results.
MATERIAL METHODS: A 47-year-old male patient was admitted to our hospital due to exposed plaque at 3 months
postoperatively. The patient has gustillo type 3 a open fracture in the tibia 1/3 proximal tibia after accident. Removing the
plaques from the orthopedic department were seemed appropriate. Primary repair wasn’t done because there was no left
lateral skin defect. Medial sural artery perforator flap was planned for soft tissue defect of 5x9 cm on tibial bone exposition at
the medial surface. Marking with hand doppler and flap drawings are completed. The flap was removed via two perforators.
The dissections were completed within the Gastrocnemius sheath and tunneled under the defect. The injured parts of the
gastrocnemius muscle were then repaired with 3-0 vicryl. Flap donor site was partially reduced and STSG was placed in the
defect. There was no problem following the flap.
CONCLUSION: It is an effective method to minimize the loss of power in the lower extremity of the patient by avoiding the
sacrifice of the gastrocnemius muscle. The medial sural artery perforator flaps are most useful flaps for avoiding muscle
Keywords: Medial Sural Artery, Perforator Flap, Lower Extremity