Kim Kyu Nam, Kim Sang Il, Ha Won, Yoon Chi Sun
a Department of Plastic and Reconstructive Surgery , Konyang University Hospital, University of Konyang College of Medicine, Myunggok Medical Research Center , Daejeon , South Korea.
b Department of Plastic and Reconstructive Surgery , Ulsan University Hospital, University of Ulsan College of Medicine , Ulsan , South Korea.
J Plast Surg Hand Surg. 2017 Dec;51(6):387-392. doi: 10.1080/2000656X.2017.1279622. Epub 2017 Jan 26.
Reconstruction of the popliteal fossa using a free flap is challenging. Therefore, to facilitate easier free flap reconstruction of the popliteal fossa, we use a medial sural artery perforator (MSAP) free flap with a medial sural vessel as the recipient vessel, as it provides several advantages based on many reports.
This report describes the authors' experience and outcomes with this technique. Between October 2010 and January 2015, 10 patients with medium-sized defects in their popliteal fossa underwent MSAP free flap reconstruction using the medial sural vessel as the recipient vessel. The flap size and thickness were evaluated, as well as the pedicle length, for each case.
The skin flap sizes ranged from 60-112 cm. The average flap thickness was 6 mm (range = 4-8 mm), and the average pedicle length was 7.5 cm (range = 6-9 cm). Full flap survival was observed in nine cases, and flap tip necrosis was observed in one case during a mean follow-up of 15 months (range = 3-36 months). MSAP free flap reconstruction was performed for moderate-sized defects in the popliteal fossa, using the medial sural vessel as the recipient vessel.
The obvious advantages of this technique included simple vascular anastomosis (minimal size discrepancy), no intraoperative position changes, and good aesthetic outcomes (replacing like with like).
使用游离皮瓣重建腘窝具有挑战性。因此，为便于更轻松地进行腘窝游离皮瓣重建，我们使用以腓肠内侧血管为受区血管的腓肠内侧动脉穿支（MSAP）游离皮瓣，因为众多报道显示其具有诸多优势。
本报告描述了作者使用该技术的经验及结果。2010年10月至2015年1月期间，10例腘窝存在中等大小缺损的患者接受了以腓肠内侧血管为受区血管的MSAP游离皮瓣重建术。对每例患者的皮瓣大小、厚度以及蒂长进行了评估。
皮瓣面积范围为60 - 112平方厘米。平均皮瓣厚度为6毫米（范围 = 4 - 8毫米），平均蒂长为7.5厘米（范围 = 6 - 9厘米）。在平均15个月（范围 = 3 - 36个月）的随访中，9例皮瓣完全存活，1例出现皮瓣尖端坏死。采用以腓肠内侧血管为受区血管的MSAP游离皮瓣重建术治疗腘窝中等大小的缺损。
该技术的显著优势包括血管吻合简单（血管口径差异最小）、术中无需改变体位以及美学效果良好（以相似组织修复）。
