The Anatomy and Clinic Application of Free Medial Sural Artery Perforator 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 suitable 21 clinic cases in our department
Cavadas :(Plast. Reconstr. Surg. 108: , 2001) Geoffrey G. Hallock: (Annals of Plastic Surgery 52: )
Shao-liang chen: (Trauma 58: , 2005) Hyo Heon Kim :(Plastic and Reconstructive Surgery 117: ,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 women Age : 16 to 51 years Recipient site :14 hands, and 7 feet. Pay attention to the proximal major perforator
Enormous function of the Doppler ultrasound.
skin Subcutaneous Tissue Deep Fascia Muscular Tissue
Supine or prone position Exsanguination and tourniquet control. preserve a superficial vein of the flap. Detach the flap beneath the deep fascia.
Superficial veinPerforator Secondary branch of the medial sural artery
Intramuscular retrograde dissection Adequate 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 necrosis flap size :7.0×4.5cm to 12×8 cm. 17 flaps with single perforator, 4 flaps with 2 perforators. superficial vein of 16 flaps were anastomosed
Little damage to donor site Suitable for shallow defects A long vessel pedicle Can reconstruct sensation
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