Taoyuan, Taiwan From the Departments of Plastic and Reconstructive Surgery and Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University.
Plast Reconstr Surg. 2010 Apr;125(4):1135-1145. doi: 10.1097/PRS.0b013e3181d180ac.
The medial sural artery perforator flap is a thin and pliable flap. This study investigated the perforator topography of the medial sural artery perforator flap and its clinical application in head and neck reconstruction.
From January of 2005 to April of 2009, 29 patients with 29 medial gastrocnemius territories were evaluated. Among them, 26 patients underwent head and neck reconstruction using 26 medial sural artery perforator flaps. The number, location, and topographic patterns of the perforators were measured.
Flap sizes ranged from 8 x 4 cm to 12 x 14 cm. The mean pedicle length was 12.7 cm, the mean flap thickness was 4.8 mm, the mean number of total perforators was 2.7 +/- 1.5 (range, 1 to 5), and the mean number of sizable perforators was 1.6 +/- 0.7 (range, 1 to 3). The mean distance from the perforator perpendicular to the popliteal crease was 11.4 +/- 2.7 cm. No perforators were found less than 6 cm or more than 18 cm from the popliteal crease. Most sizable perforators (85.4 percent) entered the medial gastrocnemius muscle at a relative distance of one-fifth to one-third of the lower leg length measured from the popliteal crease. All flaps survived, with good functional and aesthetic outcomes, except for one failed case.
The medial sural artery perforator flap is a good alternative for head and neck reconstruction, with the advantages of thin and pliable skin, a long and reliable vascular pedicle, straightforward intramuscular dissection, the possibility of chimeric flap design, and minimal donor-site morbidity.
腓肠内侧动脉穿支皮瓣是一种薄而柔韧的皮瓣。本研究调查了腓肠内侧动脉穿支皮瓣的穿支解剖，并将其应用于头颈部重建。
2005 年 1 月至 2009 年 4 月，评估了 29 例 29 个腓肠肌内侧区的患者。其中，26 例患者采用 26 个腓肠内侧动脉穿支皮瓣进行头颈部重建。测量穿支的数量、位置和分布模式。
皮瓣大小为 8 x 4 cm 至 12 x 14 cm。蒂长平均 12.7 cm，皮瓣厚度平均 4.8 mm，总穿支数平均 2.7 +/- 1.5（范围 1 至 5），有足够尺寸的穿支数平均 1.6 +/- 0.7（范围 1 至 3）。穿支垂直于腘窝皱褶的距离平均为 11.4 +/- 2.7 cm。未发现距腘窝皱褶小于 6 cm 或大于 18 cm 的穿支。大多数有足够尺寸的穿支（85.4%）进入腓肠肌内侧肌的位置相对距离为从腘窝皱褶测量的小腿长度的五分之一到三分之一。除 1 例失败外，所有皮瓣均存活，功能和美学效果良好。
腓肠内侧动脉穿支皮瓣是头颈部重建的良好选择，具有皮肤薄而柔韧、血管蒂长而可靠、肌内解剖简单、可设计嵌合皮瓣和供区损伤小的优点。
