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CC BY-NC 4.0 · Arch Plast Surg 2020; 47(04): 354-359
DOI: 10.5999/aps.2019.01921
Case Report

Extended medial sural artery perforator free flap for groin and scrotal reconstruction

Chad M. Teven 
Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, AZ, USA
,
Jason W. Yu
Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
,
Lee C. Zhao
Department of Urology, NYU Langone Health, New York, NY, USA
,
Jamie P. Levine
Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
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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 forearmbased 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.

Keywords

Extended medial sural artery perforator flap - Groin reconstruction - Medial sural artery perforator - Scrotal reconstruction - Scotoplasty


Publication History

Received: 29 December 2019

Accepted: 05 February 2020

Article published online:
25 March 2022

© 2020. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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