The Anatomical Basis of the Medial Sural Artery Perforator Flaps

Objectives: To study the perforators of the medial sural artery and the possible size of their flap. Methods: The external iliac arteries of ten adult preserved cadavers (males and females) were injected with a mixture of red latex and lead oxide. The skin was reflected and the medial sural artery and its perforators were identified. The diameters and origins of perforators were measured from the central popliteal crease. Results: The medial sural artery originated from the popliteal artery in 70% and had its external diameter at a mean of 3 ± 0.02 mm and was accompanied by two venae comitantes. The number of its perforators was at a mean of two perforators. Length of the pedicle of the medial sural artery perforator flap was at a mean of 18 ± 0.03 cm. The largest of the perforator had an average external diameter of 0.9 mm. The perforators ramified the skin with branches of the artery accompanying the posterior cutaneous nerve and the perforating branches of the peroneal and the posterior tibial arteries. The possible size of the medial sural perforators flap was at an average 8.2 cm × 13.3 cm. Conclusion: The medial sural artery perforator flap has at least one or two perforators with an average size of 8.2 cm × 13.3 cm. Elevation of the flap will not affect the vascularity of the gastrocnemius muscle. Keywords: Flap, medial sural artery, perforators, vena comitante