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- W4318026864 abstract "We read with great interest the article by Scaglioni et al. entitled “The Versatility of the Pedicled Medial Sural Artery Perforator Flap: From Simple to Its Chimeric Pattern and Clinical Experience with 37 Cases.”1 The authors describe their institutional experience using the pedicled medial sural artery perforator flap in its simple and chimeric form for reconstruction of defects in three different regions. The authors used the chimeric design in 10 cases with a 97% success rate, keeping two perforators for two skin paddles or one perforator for the skin paddle and the other for muscle1 It was interesting to notice that in five patients, one of the harvested skin paddles was used for donor-site closure, by which the need for skin graft was reduced. Although the anatomical predictability of the medial sural artery perforator (MSAP) flap is still challenging and an intramuscular dissection should be done to raise the flap, it remains a pliable and suitable alternative for other frequent flaps such as the radial forearm flap, with much lower donor-site morbidity.2 Moreover, the authors describe the potential use of the gastrocnemius muscle flap even after MSAP harvest, depending on the branching pattern of the medial sural artery.3 Dusseldorp et al. described the variability of the intramuscular arterial anatomy of the medial head of the gastrocnemius muscle, suggesting a diverge distribution of the flap and depths of intramuscular branches.3 In this manner, it is crucial to consider the vasculature pattern of the MSAP while conducting the dissection, as gastrocnemius muscle flap necrosis has been reported in two cases after MSAP harvest.4 Finally, we would like to mention the additional advantage of the MSAP flap: synchronous harvest of the plantaris tendon, sural nerve, and saphenous vein grafts from the same donor site.5 DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. No funding was received for this work. Payam Sadeghi, MDSonia Pandey, MDDepartment of Plastic SurgeryCleveland ClinicCleveland, OH" @default.
- W4318026864 created "2023-01-26" @default.
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- W4318026864 date "2022-11-15" @default.
- W4318026864 modified "2023-10-18" @default.
- W4318026864 title "The Versatility of the Pedicled Medial Sural Artery Perforator Flap: From Simple to Its Chimeric Pattern and Clinical Experience with 37 Cases" @default.
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- W4318026864 doi "https://doi.org/10.1097/prs.0000000000009870" @default.
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