Cross‐legged modification for medial sural artery perforator flap harvest. Issue 3 (9th December 2022)

• Record Type: Journal Article
• Authors: Feng, Allen L.; Spector, Matthew E.; Chinn, Steven B.; Holcomb, Andrew J.; Davies, Joel C.; Richmon, Jeremy D.; Lin, Derrick T.; Varvares, Mark A.
• Is Part Of: Head & neck. Volume 45:Issue 3(2023)
• Page Start: 752
• Page End: 756
• Publication Date: 2022-12-09
• Subjects: calf flap -- head and neck reconstruction -- medial sural artery -- MSAP flap -- perforator flap; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.27263
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: When thin and pliable free tissue is needed, the medial sural artery perforator (MSAP) flap provides an excellent option with minimal donor site morbidity. However, among its pitfalls include difficult patient positioning and surgeon ergonomics throughout the harvest. We describe a novel positioning technique that may significantly improve surgeon ergonomics and ease of MSAP flap harvest. A cross‐legged modification may eliminate many of the issues associated with the classic frog‐leg position. While the patient is cross‐legged, the surgeon is afforded a normal field of view that is closer to their body, while simultaneously providing support to the lateral side of the gastrocnemius muscle. This pictorial essay describes this positioning technique and subsequent harvest. By incorporating a more ergonomic cross‐legged position during flap elevation, many of thedrawbacks of the MSAP flap could be eliminated.