Free transplanted medial sural artery perforator flap for repair of hand-foot infectious soft tissue defects
Objective To investigate the method and clinical effect of free transplanted medial sural artery perforator(MSAP)flap in the repair of hand-foot soft tissue defects with median or mild infection.Methods A retrospective study was conducted on 11 patients with infected wounds on hands or feet,which were repaired by free transplanted MSAP flaps in Zhengzhou Renji Hospital,from Jan.2019 to Jun.2022.There were 8 males and 3 fe-males aged 31-55(mean,35.4)years,with 6 cases due to crush injuries by objects,3 cases due to crush injuries by machine,and 2 cases due to road traffic accidents.Among them,7 cases involved the foot and 4 the hand.The size of the flap was 4.0 cm×5.5 cm to 6.0 cm×13.0 cm.Results All the 11 cases were followed up for 6-18(mean 9.5)months,which revealed good appearance and elasticity,and linear scar in the donor area.All flaps survived.One case developed distal skin margin necrosis after operation,which healed after local re-debridement and dressing change;2 cases had venous crisis,which was improved after elevation of the affected limb,local massage and remov-al of partial sutures.All the infectious wounds were controlled and repaired.Conclusion The MSAP flap has the advantages of constant vascular anatomical position,reliable blood supply,easy harvest and conceal donor site,which is a good choice for repairing infectious soft tissue defects at hands or feet with a good control effect and is worthy of wide promotion.