The basic anatomy of the medial sural artery perforator flaps in Vietnamese adults

• Published in: Annals of medicine and surgery 2022-07, Vol.79, p.103996-103996, Article 103996
• Main Authors: Ngo, Khoa Xuan, Vo, Huy Tien, Nguyen, Duong Thai-Ha, Doan, Ha Thi-Ngoc
• Format: Article
• Language: English
• Subjects: Cross-sectional Study; Medial sural artery; Perforating branche; Perforator flap; Sural
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103996

Both free medial sural artery perforator flaps and pedicled medial sural artery perforator flaps have been being effectively used in treatment of body defects especially in head and neck region by plastic surgeons worldwide. However, there is a lack of comprehensive studies on the anatomy of perforating artery branches in Vietnam. This study aims to describe anatomical vascular pedicles of medial sural artery perforator flap in Vietnamese adults. A descriptive cross-sectional study, dissected 62 lower limbs of 41 Vietnamese adult cadavers preserved by formalin in Department of Anatomy, Hanoi Medical University and Ho Chi Minh Medicine and Pharmacy University. Origin of medial sural artery was branched constantly from popliteal artery. Common stem of artery was 8.39 ± 3.5 cm in mean length. The diameter of common stem, which was measured from origin, was 2.88 ± 0.98 mm averagely. The common stem of artery, which did not have any branch (15%), divided in to 2 branches (15%), 3 branches (30%), 4 branches (40%) before entering muscle. Medial sural artery had 1 to 5 branches perforating to the skin. The distance from perforating branch to the knee joint (popliteal crease) was 10.12 ± 3.7 cm, the distance from perforator branch to middle posterior leg was 1.6 ± 0.96 cm. The medial sural artery constantly originates from popliteal artery, supplies blood for medial gastrocnemius muscle. The skin area covering this muscle is nourished by one of five perforators of the medial sural artery. The perforating flaps can be created using medial sural artery perforating branches. The following observations are derived from investigation of 62 lower extremities in 41 Vietnamese adult cadavers:−55/62 specimens had 1 medial sural artery, accounting for 88.71%, 7/62 specimens had 2 supplying arteries, accounting for 11.29%.−Origins: Medial sural artery divided from the posterior side of popliteal artery. In 47/62 specimens, this artery was directly divided from popliteal artery, accounting for 75.8%. Measurements: The length of main truck from the origin pedicle to the last muscle navel was around from 12.57 mm to 17.74 mm, mean ± SD was 14.75 mm ± 3.5 mm. The diameter of main truck at the origin, where popliteal artery gave off the sural artery, was 1.74 mm for minima and 4.88 mm for maxima, mean ± SD was 3.4 ± 0.92 mm.−Branches of main truck of medial sural artery: 15% had no branches, 15% gave off 2 branches, 30% gave off 3 branches and 40% gave off 4 branches before pierci