Titus Helen Mary, Sreedevi Sarath Radhakrishnapillai, Parameswaran Sabu Chaniveliyil, Malathi Lekshmi
Department of Plastic and Reconstructive Surgery, Government Medical College Kottayam, Kottayam, Kerala, India.
Indian J Plast Surg. 2024 Mar 18;57(2):140-146. doi: 10.1055/s-0044-1782201. eCollection 2024 Apr.
The medial sural artery perforator (MSAP) flap was described by Cavadas et al in 2001. The aim of this study was to analyze the flap characteristics in the regional population and was planned as a cadaveric dissection study. Thirty-three legs of fresh cadavers were studied for perforator characteristics, length, and origin of pedicle and skin paddle thickness. Observations were documented and analyzed. Seventeen right legs (51.5%) and sixteen left legs (48.5%) were studied. Twenty-five pedicles originated from popliteal artery (86.2%) and four (13.8%) from the common sural trunk. No perforators were seen in four legs. The mean number of perforators is 2 (0-6). The mean distance of perforator from midpoint of popliteal fossa was 10.7 cm (8-13 cm) and from posterior midline it was 3.2 cm. The mean size of the perforator was 1.1 ± 0.8 mm (0.8-1.5 mm). The mean pedicle length was 9.3 ± 1.3 cm. The mean flap thickness was 4.3 ± 0.7 mm (3.0-5.5 mm). There was no correlation for flap or perforator characteristics with side of leg. This study concludes that MSAP is a good flap in terms of perforator characteristics, pedicle length, and flap thickness, when a medium sized thin flap with long pedicle is needed. The location of perforator on calf varies in different population. Being a perforator flap, anatomical variability is common and should be thought of while choosing this flap.
腓肠内侧动脉穿支（MSAP）皮瓣由卡瓦达斯等人于2001年首次描述。本研究旨在分析该皮瓣在本地区人群中的特点，并计划进行尸体解剖研究。
对33条新鲜尸体的下肢进行了穿支特点、蒂的长度和起源以及皮瓣厚度的研究。记录并分析观察结果。
共研究了17条右腿（51.5%）和16条左腿（48.5%）。25条蒂起源于腘动脉（86.2%），4条（13.8%）起源于腓肠总干。4条腿未发现穿支。穿支的平均数量为2条（0 - 6条）。穿支距腘窝中点的平均距离为10.7厘米（8 - 13厘米），距后正中线的平均距离为3.2厘米。穿支的平均大小为1.1±0.8毫米（0.8 - 1.5毫米）。蒂的平均长度为9.3±1.3厘米。皮瓣的平均厚度为4.3±0.7毫米（3.0 - 5.5毫米）。皮瓣或穿支特点与下肢侧别无关。
本研究得出结论，当需要一个蒂长的中等大小薄皮瓣时，就穿支特点、蒂长和皮瓣厚度而言，MSAP皮瓣是一个良好的皮瓣。穿支在小腿上的位置在不同人群中有所不同。作为一个穿支皮瓣，解剖变异很常见，在选择该皮瓣时应予以考虑。
