Open AccessSplit median superficial sural artery perforator (MSSAP) flap and medial sural artery perforator (MSAP) flap for posterior thigh sarcoma reconstruction
Author(s) -
Natalia Mazur,
Rik Osinga,
Steven Lo
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-233352
Subject(s) - medicine , perforator flaps , surgery , skin grafting , muscle contracture , thigh , anatomy , posterior tibial artery , artery
Reconstruction of composite defects of the posterior thigh and knee is challenging. Pedicled medial gastrocnemius flaps are the traditional reconstructive approach, but late contractures related to skin grafted muscle may affect knee function. More recently, the medial sural artery perforator (MSAP) flap has been described for such defects, although may necessitate skin grafting of the donor site. To minimise the drawbacks with these options, we describe a combination of a median superficial sural artery perforator (MSSAP) flap and MSAP flap. This allows both tension free closure of the donor site without skin grafting, and facilitates coverage of a round defect by splitting the flap into two adjacent triangular flaps. This is the first report of posterior thigh defect reconstruction with a combination of MSSAP and MSAP flaps.