{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T14:39:23Z","timestamp":1778769563386,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Reconstruction of knee defects still represents a challenge for reconstructive surgeons. After an extensive resection, the primary aim is to reach a stable result, while maintaining a good range of motion and aesthetic unity. The use of pedicled perforator\u2010based flaps makes it possible to achieve these goals. Many are the flaps that can be used in this region, and the pedicle medial sural artery perforator (mSAP) flap is considered among one of the first\u2010choice techniques. The purpose of this case report is to describe for the first time the use of pedicled mSAP flap to cover a lateral knee defect. A 79\u2010year\u2010old patient underwent extensive excision of sarcoma on the lateral side of the left knee, with removal of distal portion of the vastus lateralis muscle and portion of the biceps femoris tendon. The resulting defect from the excision measured 10\u2009cm\u2009\u00d7\u200910\u2009cm. To cover the postero\u2010inferior part of the defect we decided to use a mSAP flap, with a skin paddle 10\u2009cm\u2009\u00d7\u20095\u2009cm, which was tunneled posteriorly to the popliteal artery and vein in order to reach the affected site. We then used a lower medial thigh perforator (pLMT) flap with a 15\u2009cm\u2009\u00d7\u20095\u2009cm skin paddle, rotated by 90\u00b0 in a propeller fashion to cover the antero\u2010superior portion of the defect. The decision to use two flaps was justified by the fact we wanted to close the donor areas with direct suturing for a better aesthetic result. The post\u2010operative course was regular with only a small wound dehiscence that had healed by secondary intention. At 6\u2009months postoperatively, the patient showed a complete active range of motion of the knee joint and absolute aesthetic satisfaction with flaps donor site and knee shape. A review of literature is also provided, with a specific focus on the different procedures for soft tissue defects reconstruction around the knee. According to our experience, the pedicle of the MSAP flap may be safely used as an additional reconstructive option for lateral knee defects.<\/jats:p>","DOI":"10.1002\/micr.31125","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T09:55:35Z","timestamp":1697190935000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Combined use of lower medial thigh perforator (<scp>LMTP<\/scp>) flap and pedicled medial sural artery perforator flap (<scp>MSAP<\/scp>) for lateral knee defects coverage after sarcoma resection: A case report and literature review of soft tissue defect around knee reconstruction"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2842-4553","authenticated-orcid":false,"given":"Alice","family":"Alban","sequence":"first","affiliation":[{"name":"Depatment of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-6985","authenticated-orcid":false,"given":"Matteo","family":"Meroni","sequence":"additional","affiliation":[{"name":"Depatment of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital Lucerne Switzerland"},{"name":"Department of Health Sciences and Medicine University of Lucerne Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Medicine University of Lucerne Lucerne Switzerland"},{"name":"Department of Orthopedic Surgery Luzerner Kantonsspital Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-9140","authenticated-orcid":false,"given":"Mario F.","family":"Scaglioni","sequence":"additional","affiliation":[{"name":"Depatment of Hand\u2010 and Plastic Surgery Luzerner Kantonsspital Lucerne Switzerland"},{"name":"Department of Health Sciences and Medicine University of Lucerne Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BTK.0b013e3181a7eaec"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11751-018-0319-9"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004107"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200111000-00027"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004255"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.1999.3250"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31824e5e6e"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v5.i5.603"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.31024"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.982669"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000207077.19601.86"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001544"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01401"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004854"},{"issue":"3","key":"e_1_2_6_16_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1055\/s-0040-1715919","article-title":"Outcomes of the pedicled medial sural artery perforator flap for soft tissue reconstruction around the knee: When to use it and how to look after it","volume":"14","author":"Narayan N.","year":"2020","journal-title":"Journal of Hand and Microsurgery"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/02844319509008969"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30030"},{"key":"e_1_2_6_19_1","first-page":"298","article-title":"Lower medial thigh perforator (LMTP) propeller flap for reconstruction of soft tissue defects around the knee","volume":"1","author":"Scaglioni M. 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