{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:15:44Z","timestamp":1787242544768,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The medial sural artery perforator flap is a versatile option in reconstructive microsurgery. However, most reports of this flap have been limited by sample size. This study reviews the experience of a single large-volume center using the medial sural artery perforator flap and its variants for a variety of reconstructive purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of all patients who received the medial sural artery perforator flap reconstruction between March of 2006 and July of 2014 was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Two-hundred medial sural artery perforator flaps were used at three anatomical regions: head and neck (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 129), upper extremity (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 47), and lower extremity (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 24). Flaps were transferred as free (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 189) and pedicled (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11). Overall flap survival was 96 percent. Flap variants used included chimeric flap (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11) and dual skin paddle (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 2). Plantaris tendon and saphenous\/sural nerve graft were harvested in conjunction in 20 and seven patients, respectively. In 5 percent of the cases harvested in the conventional manner, a reliable perforator could not be found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The medial sural artery perforator flap is a reliable, alternative workhorse flap for nearly any small- to medium-size defect. It can be harvested as free or pedicled and the option to include multiple tissue components further expands its versatility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Therapeutic, IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/prs.0000000000007282","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T17:16:12Z","timestamp":1598462172000},"page":"630e-641e","source":"Crossref","is-referenced-by-count":40,"title":["The Medial Sural Artery Perforator Flap: Lessons Learned from 200 Consecutive Cases"],"prefix":"10.1097","volume":"146","author":[{"given":"Nidal F. AL","family":"Deek","sequence":"first","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo-Chun","family":"Hsiao","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas T.","family":"Do","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huang-Kai","family":"Kao","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Chen","family":"Hsu","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8,24]]},"reference":[{"key":"R1-20230801","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1097\/00006534-200111000-00027","article-title":"The medial sural artery perforator free flap.","volume":"108","author":"Cavadas","year":"2001","journal-title":"Plast Reconstr Surg"},{"key":"R2-20230801","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/00006534-197509000-00001","article-title":"The anatomy of several free flap donor sites.","volume":"56","author":"Taylor","year":"1975","journal-title":"Plast Reconstr Surg"},{"key":"R3-20230801","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/micr.22223","article-title":"Analysis of risk factors associated with microvascular free flap failure using a multi-institutional 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Reconstr Aesthet Surg"},{"key":"R13-20230801","first-page":"736","article-title":"The medial sural artery perforator flap: A versatile donor site for hand reconstruction.","volume":"70","author":"Lin","year":"2011","journal-title":"J Trauma"},{"key":"R14-20230801","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/01.sap.0000116242.26334.b5","article-title":"The medial sural artery perforators: Anatomic basis for a surgical plan.","volume":"53","author":"Thione","year":"2004","journal-title":"Ann Plast Surg"},{"key":"R15-20230801","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/PRS.0b013e3182729e3c","article-title":"Reconstruction of distal limb defects with the free medial sural artery perforator flap.","volume":"131","author":"Wang","year":"2013","journal-title":"Plast Reconstr Surg"},{"key":"R16-20230801","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/SAP.0b013e31821190e6","article-title":"Medial sural artery perforator 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A systematic review and meta-analysis.","volume":"143","author":"Daar","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"Suppl 1","key":"R20-20230801","doi-asserted-by":"crossref","first-page":"S86","DOI":"10.1097\/SAP.0000000000001697","article-title":"Extended use of chimeric medial sural artery perforator flap for 3-dimensional defect reconstruction.","volume":"82","author":"Lee","year":"2019","journal-title":"Ann Plast Surg"},{"key":"R21-20230801","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1097\/01.PRS.0000133171.65075.81","article-title":"Free-style free flaps.","volume":"114","author":"Wei","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"R22-20230801","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1002\/micr.22264","article-title":"The proximal lateral lower leg perforator flap revisited: Anatomical study and clinical applications.","volume":"35","author":"Lee","year":"2015","journal-title":"Microsurgery"},{"key":"R23-20230801","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1097\/00006534-200110000-00007","article-title":"The outcome of failed free flaps in head and neck and extremity reconstruction: What is next in the reconstructive ladder?","volume":"108","author":"Wei","year":"2001","journal-title":"Plast Reconstr Surg"}],"container-title":["Plastic &amp; Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007282","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T19:15:58Z","timestamp":1690917358000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,24]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/prs.0000000000007282","relation":{},"ISSN":["0032-1052"],"issn-type":[{"value":"0032-1052","type":"print"}],"subject":[],"published":{"date-parts":[[2020,8,24]]}}}