Medial sural artery perforator free flap for the repair of limb soft tissue defects

OU Chang-liang; ZHOU Xin; ZOU Yong-gen; LUO Xu-chao; YANG Jie-xiang; PENG Zhong-yi

doi:10.3969/j.issn.1009-4237.2018.06.002

Abstract：Objective To explore clinical effects of the medial sural artery perforator free flap in the repair of limb soft tissue defects.Methods From Jan.2014 to Jun.2016,10 cases of soft tissue defects of the limbs were re-paired with perforator flap of the medial sural artery in the Department of Hand Surgery ,Chinese Traditional Medicine Hospital Affiliated to Southwest Medical University ,including 7 males and 3 females,age ranged between 19 and 58 (average age 38.5) years.There were 6 cases of road traffic injuries,3 cases of mechanical injuries and 1 case of crush injury.There were 6 cases of soft tissue defects in the hand ,4 cases of soft tissue defect in the dorsal foot.De-fect area was in the range of 12.5cm×8cm-8cm×4cm,with an average area of 10.5cm×6cm.The color doppler flow detector was used to detect perforator vessels before operation ,the number of perforator vessels and vascular pedicle length were recorded intraoperatively.Flap cutting ranged between 8.5cm×4cm and 13cm×8cm,and supply area in 5 cases were directly sutured.The supply area width was greater than 5cm,and was repaired with skin grafts in the ab-domen or thighs.The time was 2 to 4 weeks for flap transplantation after surgery.Results All of the flaps survived successfully.Patients were followed up for 6 to 18 months.The transplanted flap was beautiful in appearance,free from bloated,and had good texture and satisfactory function.The supply area healed well and there was no significant depres-sion.Conclusion The medial sural artery perforator free flap is a good method for repairing soft tissue defects of the limbs,which is rich in blood supply,has a constant vascular anatomy and is moderate in thickness.