Application Of Medial Sural Artery Perforator Free Flaps In The Reconstruction Of Defect After Tongue Carcinoma Surgery

Objective:To investigate the method, effectiveness and clinical application of medial sural artery perforator free flaps to reconstruct the defect of tongue carcinoma ablation.Methods:From March2013to February2014, the defects after tongue carcinoma resection were reconstructed with medial sural artery perforator free flaps in6patients. Medial gastrocnemius territories were evaluated before operation by held Doppler. The clinical data were collected and analyzed, including site and histology of tumor, the skin paddle’s size of the flap, the length of pedicle, the number and location of major perforators and donor-site morbidity.Result:The average time of total operation was6.65hours and flap harvest time was65minutes. The sizes of the skin paddle varied from3.5cm*4cm to6.5cm*6cm. The mean length of pedicle was8.75cm (ranged,7cm to11cm). The number of perforators was1or2, which was the same with the preoperative result collected by the handheld Doppler. The mean distance from the perforator perpendicular to the popliteal crease was9.75cm (ranged,8.5cm to11cm) and to the midline of the gastrocnemius muscles was1.0cm (ranged,0.1cm to2.0cm).The donor site was primarily closed in all cases and all of them healed in first intention. Long-term follow-up showed satisfying receipt-site reconstruction results with good functional and cosmetic outcome in the donor site. Except minor sensory deficit in the donor site, there was on obvious donor site morbidity observed in all the cases.Conclusion:The medial sural artery perforator flap is reliable for reconstruction of the small to medium-sized defect after tongue carcinoma ablation with less donor site morbidity.