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S.B. Butsan

National Medical Research Center of Dentistry and Maxillofacial Surgery

K.S. Salikhov

National Medical Research Center of Dentistry and Maxillofacial Surgery

M.N. Bolshakov

Central Research Institute of Dentistry and Maxillofacial Surgery;
Russian Medical Academy of Continuous Professional Education

A.A. Gaibadulina

National Medical Research Center of Dentistry and Maxillofacial Surgery

A.S. Dobrodeev

Central Research Institute of Dentistry and Maxillofacial Surgery

S.G. Bulat

National Medical Research Center of Dentistry and Maxillofacial Surgery

Midface soft tissue defect closure with medial sural artery perforator flap

Authors:

S.B. Butsan, K.S. Salikhov, M.N. Bolshakov, A.A. Gaibadulina, A.S. Dobrodeev, S.G. Bulat

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2022;(3): 31‑42

DOI: 10.17116/plast.hirurgia202203131

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Table of contents

MIDFACE SOFT TISSUE DEFECT CLOSURE WITH MEDIAL SURAL ARTERY PERFORATOR FLAP
MIDFACE SOFT TISSUE DEFECT CLOSURE WITH MEDIAL SURAL ARTERY PERFORATOR FLAP

To cite this article:

Butsan SB, Salikhov KS, Bolshakov MN, Gaibadulina AA, Dobrodeev AS, Bulat SG. Midface soft tissue defect closure with medial sural artery perforator flap. Plastic Surgery and Aesthetic Medicine. 2022;(3):31‑42. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202203131

Кардиологические дебаты — VI. Версия 2.0
Здоровье щитовидной железы – 2024
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OBJECTIVE

To increase the efficiency of surgical treatment and rehabilitation of patients with midface soft tissue defects.

MATERIAL AND METHODS

There were 11 patients with defects and deformations of the midface. Ten ones underwent defect closure with medial sural artery perforator flap (MSAP-flap). We elucidated the etiology of defects. Subsequently, they were divided according to classification invented by J.S. Brown and R.J. Shaw (2010). We assessed surgical and anesthetic risks using the ACS NSQIP calculator. We determined the main clinical characteristics of the flap and possibilities of its application: dimensions and thickness of the flap, number of perforators supplying the flap, length of vascular pedicle. Follow-up of patients allowed determining the donor damage.

RESULTS

We used MSAP-flap in 10 out of 11 cases for midface defect repair. In one case, we intraoperatively decided not to use the MSAP-flap. Mean area of defect was 22.9 cm2. Dimensions of the dissected flaps ranged from 3×4 cm to 9×8 cm, vascular pedicle length from 11 to 16 cm, thickness from 0.4 to 0.9 cm. In three cases, two perforators per a flap were preserved. Recipient vessels were superior thyroid, facial, submandibular, superficial temporal arteries and veins, as well as lingual vein. According to the ACS NSQIP Surgical Risk Calculator, mean surgical risk of major complications was 25.16%, any other complications — 30.53%.

CONCLUSION

MSAP-flap is an appropriate material for midface soft tissue defect closure due to constant anatomy of posteromedial surface of the tibia, small thickness of subcutaneous fat, variability of flap sizes, vascular pedicle length and minimal donor damage.

Keywords:

midface defect
microsurgery
perforator flap
sural flap

Authors:

S.B. Butsan

National Medical Research Center of Dentistry and Maxillofacial Surgery

K.S. Salikhov

National Medical Research Center of Dentistry and Maxillofacial Surgery

M.N. Bolshakov

Central Research Institute of Dentistry and Maxillofacial Surgery;
Russian Medical Academy of Continuous Professional Education

A.A. Gaibadulina

National Medical Research Center of Dentistry and Maxillofacial Surgery

A.S. Dobrodeev

Central Research Institute of Dentistry and Maxillofacial Surgery

S.G. Bulat

National Medical Research Center of Dentistry and Maxillofacial Surgery

Received:

15.11.2021

Accepted:

16.03.2022

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