Varied uses of the medial sural artery perforator flap

SummaryBackground and aimThe aim of the study was to demonstrate how the medial sural artery perforator flap can be used in a wide range of settings and not focused on one area, as previous papers have done. We also wanted to demonstrate that larger flaps can be harvested from the donor site and still closed directly to optimise the appearance of the donor site.MethodsWe describe the use of the medial sural artery perforator flap in 18 patients with defects of the head and neck, upper and lower limbs.ResultsAll 18 flaps survived, although one suffered some delayed partial loss due to pressure damage. All donor sites were closed directly to optimise the appearance of the donor site. There were complications with the donor site wound in 2 patients. This resulted in further surgery in one case.ConclusionThe advantages of the flap are discussed over some of the more commonly used options for reconstruction of these areas. It is a good source of thin, pliable soft tissue with a long pedicle, which makes it very adaptable. The skin paddle is small but if designed appropriately allows the donor site to be closed directly, leaving an aesthetically good result.