Plastic Surgery Department, PNS Shifa Hospital Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2023 Jul-Sep;35(3):375-379. doi: 10.55519/JAMC-03-11969.
Reconstruction of defects around the knee and proximal leg are difficult to reconstruct. Out of the multiple flaps described for reconstruction, the pedicled Medial Sural Artery Perforating Flap (MSAP) has recently gained popularity. We conducted this study to assess the clinical outcomes of pedicled MSAP for this purpose at our hospital.
A descriptive case series was conducted from April 2022 to March 2023. All patients above 18 years with defects around the knee and proximal leg were included. Patients with tissue loss in the calf area were excluded.
A total of 14 patients were included. Twelve (86%) were males, while only 2 were females (14%). The mean age was 33.5 years (±8.76). The most common cause of the defect was trauma (n=11, 85%). The Mean distance of the distal-most perforator from the popliteal crease was 12.714 (±1.990) cm (range 9-16 cm). It was observed that the most distal perforator is usually present in a 2 cm radius of the medial musculo-tendinous junction of the gastrocnemius. Complications were seen in 2 (14%) patients. The mean duration of hospital stay was 4.2 (±0.96) days. Patients were followed up weekly for the first two weeks and then at 1, 3 and 6 months.
MSAP Flap is a reliable thin, long pedicled fasciocutaneous flap with low donor site morbidity and aesthetically good results for reconstruction around the knee and proximal leg.
膝关节和小腿近端周围的缺损重建较为困难。在用于重建的多种皮瓣中，带蒂的内侧腓肠肌动脉穿支皮瓣（MSAP）最近越来越受欢迎。我们在本院进行这项研究，旨在评估该皮瓣在这方面的临床效果。
这是一项 2022 年 4 月至 2023 年 3 月期间进行的描述性病例系列研究。所有年龄大于 18 岁、膝关节和小腿近端有缺损的患者均纳入研究。小腿区域有组织缺失的患者被排除在外。
共纳入 14 例患者。其中 12 例（86%）为男性，仅 2 例（14%）为女性。平均年龄为 33.5 岁（±8.76）。缺损最常见的原因是创伤（n=11，85%）。远端最远处穿支距腘窝皱褶的平均距离为 12.714（±1.990）cm（范围 9-16cm）。观察到最远端的穿支通常位于腓肠肌内外侧肌肌腱联合的 2cm 半径内。有 2 例（14%）患者出现并发症。平均住院时间为 4.2（±0.96）天。患者在最初的两周内每周进行一次随访，然后在 1、3 和 6 个月时进行随访。
MSAP 皮瓣是一种可靠的、薄而长的带蒂筋膜皮瓣，具有较低的供区并发症发生率，且膝关节和小腿近端重建后的美学效果良好。
