Donor Site Morbidity of the Medial Sural Artery Perforator (MSAP) Free Flap for Head & Neck Reconstruction.

Abstract

Minimal donor site morbidity is often cited as one of the main advantages of the medial sural artery perforator (MSAP) free flap; however, few studies have examined functional outcomes. This retrospective cohort study analyzed patients undergoing MSAP for head and neck reconstruction from 2022 to 2024. A modified lower extremity functional scale (LEFS), with 80 being a maximum score, was administered to assess functional morbidity. Twenty two patients underwent successful MSAP flap. At < 1 month after surgery, the average LEFS was 56.0 (95% CI, 43.8-68.2). At 1-3 months, the average score was 63.0 (95% CI, 56.0-70.0); at 3-6 months, it was 75.0 (95% CI, 70.0-80.0), and at 6-12 months, it was 78.1 (95% CI, 75.4-80.0). Beyond 12 months, the average score was 79.8 (95% CI, 79.8-80.0). The MSAP free flap is an excellent free tissue option for head & neck reconstruction with minimal donor site morbidity.