Medial sural artery perforator flap for postsurgical reconstruction of head and neck cancer.

BACKGROUND: This article aims to describe the application of medial sural artery perforator flaps (MSAPs) in reconstruction of defects following ablation of head and neck cancer.

METHODS: The study included 24 patients (10 males and 14 females). A total of 24 MSAPs were harvested to reconstruct defects caused by the dissection of malignant tumors of the oral and maxillofacial regions. Overall, 20 radial forearm free flaps (RFFs) and 16 anterior lateral thigh perforator flaps (ALTPs) were included in the donor site cosmetic assessments. Visual analog scale (VAS) score was used to assess postoperative oral function and cosmetic results.

RESULTS: A total of 22 (92%) flaps healed without venous insufficiency. The external diameter of the medial sural artery for anastomosis was 2.2 mm (range, 1.3-2.5 mm), and the external diameter of the venae comitantes was 2.6 mm (range, 1.5-3.5 mm). Esthetic satisfaction with the primary site had a VAS score of 6.38 ± 1.89, while the donor site had a score of 7.34 ± 1.28. Use of MSAP and ALTP showed significantly higher esthetic satisfaction at the donor site than with RFF (p < 0.001 and p < 0.05, respectively).

CONCLUSION: MSAPs show a strong advantage for donor site esthetic outcome and can be a good choice for the repair of defects of the maxillofacial area after cancer ablation.