Chapter 3 The MSAP flap was drawn oval and centred with its major axis on the MGML as represented in Fig. 3.1; the superior border of the flap was at 6 cm from the popliteal crease. Supine cadavers Dissection began at the anterior border of the drawing and continued in an anteroposterior direction. Prone cadavers Dissection began at posterior border and continued in a posteroanterior direction. In the subfascial plane, perforators overlying the medial gastrocnemius muscle were identified and followed within the muscle substance, clipping the multitude of muscular branches, up to their origin from the medial sural artery and then up to the popliteal artery; considerable assistance is required because dissection got deeper within the muscle. The remaining skin was finally incised and the flap was detached from the limb. (Fig.3.2) Figure 3.2 MSAP flap based on 2 perforators detached from the cadaver. 35
5. lay-out phd DEFINITIEF_digitaal2
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