The free medial sural artery perforator flap: Versatile option for soft tissue reconstruction in small‐to‐moderate size defects of the foot and ankle

Abstract

The MSAP flap provides thin soft tissue coverage, enabling good functional recovery after defect reconstruction all around the foot and ankle, with evident advantages in the midfoot. However, the functional outcomes after reconstruction of the ankle-hindfoot or hallux region depend on the preexistent functional impairment.

A Systematic Review of Outcomes and Flap Selection Following Lower Extremity Free Tissue Transfer Versus Vascularized Perforator Pedicle Flap Transfer in Lower Limb Reconstruction

“…Scores were reported to be statistically insignificant for the subjective qualityof-life measurement using the SF-36. This study concluded the free MSAP flap a reliable option in reconstruction of small-to-moderate sized defects of the foot and ankle due to its thin and pliable aesthetic appearance and its evident advantages in the midfoot (p = 0.265) with a reliable vascular pedicle [8].…”

“…Free tissue transfer has been considered the mainstay of treatment for reconstruction of the traumatized lower limb over the past few decades due to local and regional flaps often having an unreliable blood supply and insufficient local donor tissue [18]. The most widely used and most suited free flap for reconstruction of soft tissue defects of the lower extremity is said to be the free ALT flap [8,9]. When undergoing reconstruction for diabetic foot ulcers the goal in treatment by way of free tissue transfer is to provide a flap with adequate bulk, shock absorption, and durability against the shearing forces of ambulation [9,12].…”

“…Free tissue transfer with the MSAP flap was reviewed in three separate studies for reconstruction of the lower limb; repairing penetrating wounds of the foot, repairing anterior dorsal foot wounds, and in soft tissue reconstruction of small-to-moderate sized defects of the foot and ankle [6,7,8].…”

“…Reconstruction using the free MSAP flap for small-tomoderate sized soft tissue defects was reviewed in 22 patients evaluating its versatility by comparing outcomes at the foot and ankle [8]. Etiologies (Table 3) of the soft tissue defects were posttraumatic (n = 5), ischemic-PAD with or without diabetic foot syndrome (n = 16), and posttraumatic defects with preexistent PAD (n = 1).…”

Predictors of Clinical Outcome after Reconstruction of Complex Soft Tissue Defects Involving the Achilles Tendon with the Composite Anterolateral Thigh Flap with Vascularized Fascia Lata

“…20 In addition, all patients were evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating system, which is the most commonly used outcome tool to assess the results of treatment of foot and ankle disorders. 21 The clinician-based questionnaire has four versions, each specific according to the function of the anatomic region of the foot and ankle. Here, we only assessed the AOFAS ankle-hindfoot score.…”