Free medial sural artery perforator flap for soft tissue defects in the hand: a cadaver study.

We carried out a cadaver study using 10 fresh-frozen adult legs and hands to explore technical feasibility and reproducibility of the free Medial Sural Artery Perforator flap and its applicability for covering soft tissue defects in the hand. A mean of 2 cutaneous perforators (1-4) were found. Each flap had a pedicle composed of a main perforator that arose from the medial sural artery. Distance between the middle of the popliteal fossa and the emergence of the main perforator was 10 ± 1.9 cm. The pedicle length was 13 ± 1.6 cm. It included an artery (diameter: 2.5 ± 0.6 mm) and a vein (diameter: 3.2 ± 1.2 mm). Skin paddle thickness was 8.5 ± 1.9 mm. Using an 10 × 8 cm skin paddle, it was always possible to cover the entire palmar and dorsal sides of the hand. Our findings suggest that this free flap is a reliable and reproducible option for large cutaneous defects of the hand, offering an effective alternative to conventional flaps. LEVEL OF EVIDENCE: IV.