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A novel reconstruction technique for the knee and upper one third of lower leg
Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 927
COMMENTARY
A novel reconstruction technique for the knee and upper one third of lower leg Roderick Dunn Odstock Centre for Burns, Plastic and Maxillo-Facial Surgery Salisbury District Hospital Salisbury, Wiltshire SP2 8BJ, UK This innovative paper describes six cases using the medial sural artery perforator flap to reconstruct defects in the upper third of the lower leg and around the knee. The authors have performed anatomical dissections in 20 cadavers to discern the perforator anatomy and their conclusions are similar to previous anatomical studies (Refs. 11 and 12). They describe clearly the pre-operative markings of the perforators and demonstrate the use of the flap in six cases with no complications. This is a thin flap which can have a long pedicle (and consequent arc of rotation) when taken on its
most distal perforators. It is an alternative to the gastrocnemius muscle flap and has less donor site morbidity. Hallock has demonstrated that in the case of failure of the pedicled medial sural artery perforator flap, the gastrocnemius muscle flap is a still viable salvage option (Ref. 13). Surgeons with an enthusiasm for perforator flaps who wish to reduce the morbidity and improve the appearance of reconstructions of the upper third of the lower limb can use this flap, safe in the knowledge that the gastrocnemius muscle flap is still available as a ‘lifeboat’.
DOI of related article: 10.1016/j.bjps.2006.01.025. E-mail address: [email protected] 1748-6815/$ - see front matter ª 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2006.03.004
COMMENTARY
A novel reconstruction technique for the knee and upper one third of lower leg Roderick Dunn Odstock Centre for Burns, Plastic and Maxillo-Facial Surgery Salisbury District Hospital Salisbury, Wiltshire SP2 8BJ, UK This innovative paper describes six cases using the medial sural artery perforator flap to reconstruct defects in the upper third of the lower leg and around the knee. The authors have performed anatomical dissections in 20 cadavers to discern the perforator anatomy and their conclusions are similar to previous anatomical studies (Refs. 11 and 12). They describe clearly the pre-operative markings of the perforators and demonstrate the use of the flap in six cases with no complications. This is a thin flap which can have a long pedicle (and consequent arc of rotation) when taken on its
most distal perforators. It is an alternative to the gastrocnemius muscle flap and has less donor site morbidity. Hallock has demonstrated that in the case of failure of the pedicled medial sural artery perforator flap, the gastrocnemius muscle flap is a still viable salvage option (Ref. 13). Surgeons with an enthusiasm for perforator flaps who wish to reduce the morbidity and improve the appearance of reconstructions of the upper third of the lower limb can use this flap, safe in the knowledge that the gastrocnemius muscle flap is still available as a ‘lifeboat’.
DOI of related article: 10.1016/j.bjps.2006.01.025. E-mail address: [email protected] 1748-6815/$ - see front matter ª 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2006.03.004