Publication: Anatomy of medial plantar superficial branch artery perforators: Facilitation of medial plantar superficial branch artery perforator (MPAP) flap harvesting and design for finger pulp reconstruction
Issued Date
2018-07-01
Resource Type
ISSN
10982752
07381085
07381085
Other identifier(s)
2-s2.0-85044343297
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Mahidol University
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SCOPUS
Bibliographic Citation
Microsurgery. Vol.38, No.5 (2018), 536-543
Suggested Citation
Suphalerk Lohasammakul, Chairat Turbpaiboon, Kongkrit Chaiyasate, Parin Tatsanavivat, Supin Chompoopong, Ali Roham, Rosarin Ratanalekha, Chongdee Aojanepong Anatomy of medial plantar superficial branch artery perforators: Facilitation of medial plantar superficial branch artery perforator (MPAP) flap harvesting and design for finger pulp reconstruction. Microsurgery. Vol.38, No.5 (2018), 536-543. doi:10.1002/micr.30321 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46560
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Title
Anatomy of medial plantar superficial branch artery perforators: Facilitation of medial plantar superficial branch artery perforator (MPAP) flap harvesting and design for finger pulp reconstruction
Abstract
© 2018 Wiley Periodicals, Inc. Background: Medial plantar artery perforator (MPAP) flap was proposed as proper option for finger pulp reconstruction. To provide the previously unavailable vessel information required for this small flap design, this study aimed to gather all necessary anatomy of MPA, MPAP, and their territories of blood supply to apply in clinical MPAP flap reconstruction minimizing perforator injury. Methods: Dissection of 30 Thai cadaveric feet for visualizing superficial branch of MPA and its perforators (MPAP) using acrylic dye cannulation were performed. Diameter, length, number of branches, course, distributing areas of these vessels, and also their areas of blood supply were recorded in relation to specified landmarks, eg, C-MTH line; medial calcaneal tuberosity to plantar side of the first metatarsal head and S point; emerging point of superficial branch of MPA from deep fasciae into subcutaneous layer. Results: Average diameter of MPA at its origin and total length are 1.63 ± 0.3 and 52.8 ± 16.1 mm, respectively. It provides 1–3 perforators, with an average size and length of 0.36 ± 0.11 and 23.2 ± 5.47 mm, respectively. Its distribution is mostly in the posteromedial quadrant within 50 and 30 mm from the midpoint of C-MTH line and the S point, respectively. The estimated perforator flap area is 2.5 cm × 1.5 cm and 4.5 cm × 2.5 cm for single and double perforators, respectively. Conclusions: MPAP flap was proved as another ideal option for finger pulp reconstruction. Its limitation is small size of perforators but this can be overcome by using MPA for microsurgical anastomosis instead.