Natalie L Pease1, Andrew Davies2, William A Townley1. 1. Department of Plastic and Reconstructive Surgery, St. Thomas' Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom. 2. Department of Anatomy, Guy's Campus, King's College London, London, United Kingdom.
Abstract
BACKGROUND: The medial sural artery perforator (MSAP) flap is becoming a popular strategy for reconstructing intraoral defects. We present a case in which no MSAPs were present, however, a perforator-based calf flap was successfully raised on the sural artery and used for tongue reconstruction. A corresponding anatomic study was undertaken to establish if this finding was reproducible. METHODS: A 58-year-old woman underwent left hemiglossectomy for a squamous cell carcinoma of the tongue. Subsequently, 6 fresh frozen cadaveric limbs were dissected examining the blood supply of the posterior calf skin. RESULTS: The sural artery perforator (SAP) flap successfully reconstructed the defect. Our cadaveric study similarly demonstrated a septocutaneous SAP supplying the posterior calf skin in 1 of 6 limbs. CONCLUSION: SAPs allow a favorable flap dissection, as opposed to the musculocutaneous course of MSAPs. Our findings provide further evidence of the versatility of the calf donor site.
BACKGROUND: The medial sural artery perforator (MSAP) flap is becoming a popular strategy for reconstructing intraoral defects. We present a case in which no MSAPs were present, however, a perforator-based calf flap was successfully raised on the sural artery and used for tongue reconstruction. A corresponding anatomic study was undertaken to establish if this finding was reproducible. METHODS: A 58-year-old woman underwent left hemiglossectomy for a squamous cell carcinoma of the tongue. Subsequently, 6 fresh frozen cadaveric limbs were dissected examining the blood supply of the posterior calf skin. RESULTS: The sural artery perforator (SAP) flap successfully reconstructed the defect. Our cadaveric study similarly demonstrated a septocutaneous SAP supplying the posterior calf skin in 1 of 6 limbs. CONCLUSION: SAPs allow a favorable flap dissection, as opposed to the musculocutaneous course of MSAPs. Our findings provide further evidence of the versatility of the calfdonor site.