Medial Sural Artery Perforator (MSAP) Flap

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2025-10-31

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Abstract
The medial sural artery perforator (MSAP) flap is designed over the medial head of the gastrocnemius muscle. It is based on the perforators of the medial sural artery (MSA), which is a branch of the popliteal artery. It was first described by Hallock and Cavadas (2001) and has gained popularity as a reconstructive option for small-to-medium sized defects of the head and neck. It is a good intermediate option between radial forearm and anterolateral thigh flaps.
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