Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Extended medial sural artery perforator free flap for groin and scrotal reconstruction

  • Teven, Chad M. (Division of Plastic and Reconstructive Surgery, Mayo Clinic) ;
  • Yu, Jason W. (Hansjorg Wyss Department of Plastic Surgery, NYU Langone Health) ;
  • Zhao, Lee C. (Department of Urology, NYU Langone Health) ;
  • Levine, Jamie P. (Hansjorg Wyss Department of Plastic Surgery, NYU Langone Health)
  • Received : 2019.12.29
  • Accepted : 2020.02.05
  • Published : 2020.07.15
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Abstract

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap that has been used successfully in the reconstruction of defects across the body. In specific cases, it may prove superior to more commonly used options (e.g., anterolateral thigh flap and radial forearm free flap). Historically, a disadvantage of the MSAP flap is the relatively small surface area it provides for reconstruction. We recently encountered a patient with extensive pelvic injuries from prior trauma resulting in significant scarring and contracture of the groin, tethering of the penis, and loss of the scrotum and one testicle. The patient was unable to achieve erection from tethering and his remaining testicle had been buried in the thigh. In considering the reconstructive options, he was not a suitable candidate for a thigh-based or forearm-based flap. An extended MSAP flap measuring 25 cm×10 cm was used for resurfacing of the groin and pelvis as well as for the formation of a neoscrotum. This report is the first to document an MSAP flap utilized for simultaneous groin resurfacing and scrotoplasty. Additionally, the dimensions of this flap make it the largest recorded MSAP flap to date.

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References

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