scholarly journals Extended medial sural artery perforator free flap for groin and scrotal reconstruction

2020 ◽  
Vol 47 (4) ◽  
pp. 354-359 ◽  
Author(s):  
Chad M. Teven ◽  
Jason W. Yu ◽  
Lee C. Zhao ◽  
Jamie P. Levine
Keyword(s):  
Free Flap ◽  
The Body ◽  
Anterolateral Thigh Flap ◽  
Small Surface ◽  
Pelvic Injuries ◽  
Anterolateral Thigh ◽  
Radial Forearm ◽  
Scrotal Reconstruction ◽  
Sural Artery ◽  
Artery Perforator

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap that has been used successfully in the reconstruction of defects across the body. In specific cases, it may prove superior to more commonly used options (e.g., anterolateral thigh flap and radial forearm free flap). Historically, a disadvantage of the MSAP flap is the relatively small surface area it provides for reconstruction. We recently encountered a patient with extensive pelvic injuries from prior trauma resulting in significant scarring and contracture of the groin, tethering of the penis, and loss of the scrotum and one testicle. The patient was unable to achieve erection from tethering and his remaining testicle had been buried in the thigh. In considering the reconstructive options, he was not a suitable candidate for a thigh-based or forearmbased flap. An extended MSAP flap measuring 25 cm×10 cm was used for resurfacing of the groin and pelvis as well as for the formation of a neoscrotum. This report is the first to document an MSAP flap utilized for simultaneous groin resurfacing and scrotoplasty. Additionally, the dimensions of this flap make it the largest recorded MSAP flap to date.

scholarly journals Reconstruction of a Mangled Hand with a Thoracodorsal Artery Perforator Free Flap: A Report of Two Cases

2021 ◽  
Vol 26 (1) ◽  
pp. 57-62
Author(s):  
Hyun Sik Park ◽  
Dong-Jin Kim ◽  
Joing Ick Hwang
Keyword(s):  
Free Flap ◽  
Surgical Flaps ◽  
Perforator Flap ◽  
Free Flaps ◽  
Soft Tissue Defects ◽  
Anterolateral Thigh ◽  
Thoracodorsal Artery ◽  
Radial Forearm ◽  
Artery Perforator ◽  
Tissue Defects

Mangled hands are a severely injured condition that is a rare and challenging problem for reconstructive surgeons. Surgical flaps such as anterolateral thigh, radial forearm, or thoracodorsal artery flaps have been used for multiple-digit resurfacing. In this report, we describe two cases of complex defects that included multiple digits in patients who underwent reconstruction with thoracodorsal artery perforator (TDAP) free flaps. All massive soft tissue defects were completely covered with a TDAP free flap. The thinner perforator flap could be harvested, and the patients regained the ability to pinch and grasp. Therefore, the authors present two cases of mangled hands successfully treated with TDAP free flap.

Comparison between Free Anterolateral Thigh Flap and Free Medial Sural Artery Perforator Flap in Reconstruction of Post Traumatic Soft Tissue Defects of Dorsum of the Foot

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Abo Elhassan WS ◽  
◽  
Abulezz TA ◽  
Ali AE ◽  
Elsayed GY ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Perforator Flap ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Anterolateral Thigh ◽  
Post Traumatic ◽  
Group 2 ◽  
Sural Artery ◽  
Artery Perforator ◽  
Tissue Defects

Background: The objective of this study was to compare the pliability, the function, aesthetic outcome, complications and patient satisfaction between free anterolateral thigh flap and free medial sural artery perforator flap in reconstruction of post traumatic soft tissue defects of dorsum of the foot. Method: The study was conducted on forty patients with post traumatic soft tissue defects of the dorsum of the foot between August 2018 and August 2019. Patients were divided randomly into two groups. In group1 (20 patients), the defects were reconstructed with free anterolateral thigh perforator flap. In group 2 (20 patients), reconstruction was done by free medial sural artery perforator flap. Result: In group 1 (ALT flap), Complete flap survival was achieved in 100% of cases. Thirteen patients required secondary debulking procedures and scar revisions. In group 2 (MSAP Flap), Complete flap survival was achieved in 85% with one flap totally lost and two flaps had distal necrosis. One patient needed scar revision and another patient needed flap advancement. Conclusion: MSAP flap is superior to ALT flap. It has many advantages: it is thin, pliable, fitted to normal footwear, less hairy and there is no need for secondary procedures in most cases.

Hypopharyngeal, Esophageal, and Neck Reconstruction

2018 ◽  
Author(s):  
Steven B Chinn ◽  
Peirong Yu
Keyword(s):  
Perforator Flap ◽  
Ulnar Artery ◽  
Good Alternative ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Anterolateral Thigh ◽  
Pharyngoesophageal Reconstruction ◽  
Radial Forearm ◽  
Artery Perforator

Organ preservation protocols with radiotherapy have become the primary treatment for stage I to III laryngeal and hypopharyngeal carcinoma. Many pharyngoesophageal defects are the result of salvage laryngopharyngectomy following radiation failure, making reconstruction more challenging. Given the detrimental effects of radiation on wound healing, reconstruction bathed in saliva, and the frozen neck with poor recipient vessels, pharyngoesophageal reconstruction requires great attention to detail to avoid catastrophic complications. In this review, we detail the commonly used flaps for pharyngoesophageal reconstruction, including the radial forearm flap, anterolateral thigh flap, and jejunal flap. In recent years, the anterolateral thigh flap has become the optimal flap for this type of reconstruction due to its minimal donor-site morbidity and excellent functional outcomes. Use of a two-skin island anterolateral flap allows for pharyngoesophageal reconstruction with simultaneous neck resurfacing. The profundus artery perforator flap can be a good alternative to the anterolateral thigh flap, whereas the ulnar artery perforator flap may be a good alternative to the radial forearm flap in certain cases. We discuss recipient vessel selection and conclude by outlining important postoperative considerations. This review contains 23 figures, 3 tables and 39 references Key words: anterolateral thigh flap, anteromedial thigh flap, frozen neck, gastro-omental flap, hypopharynx, laryngeal cancer, perforator flaps, pharyngocutaneous fistula, pharyngoesophageal reconstruction, profundus artery perforator flap, radial forearm flap, tracheoesophageal puncture, transverse cervical vessels, ulnar artery perforator flap

Outcomes of Single Stage Phalloplasty by Pedicled Anterolateral Thigh Flap versus Radial Forearm Free Flap in Gender Confirming Surgery

2018 ◽  
Vol 199 (1) ◽  
pp. 206-214 ◽  
Author(s):  
Mona Ascha ◽  
Jonathan P. Massie ◽  
Shane D. Morrison ◽  
Curtis N. Crane ◽  
Mang L. Chen
Keyword(s):  
Free Flap ◽  
Single Stage ◽  
Anterolateral Thigh Flap ◽  
Radial Forearm Free Flap ◽  
Anterolateral Thigh ◽  
Radial Forearm
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