الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The quality of soft tissue reconstruction in upper and lower limbs caused by trauma, infection, burn and tumor resection affect the patient function and aesthetic outcome.
Considering functional restoration in upper and lower limbs reconstruction, the reconstructive triangle proposed by may be more logic than the traditional reconstructive ladder. This principles helps plan the indicated technique.
The better understanding of the distribution and anatomy of the perforator vessels leading to increase in the indications of perforator flaps.
Identification of the perforator can be done by Doppler probe to help in the detection of the perforator position .+ Other radiological methods such as computed tomography(CT) angiography and color Doppler ultrasound can give more details of the anatomy of the underlying perforator.
In this study twenty MSAP flaps had been performed for upper and lower extremities soft tissue defects: ten pedicles and ten free, six for upper limb and 14 for lower limb, six females and 14 males. The ages range from 6 to 56 years old.
Reconstruction of upper and lower limbs requires a thin flap. The radial forearm flap had gained popularity in the past but with the disadvantage of significant donor site morbidity. The medial sural artery perforator flap can be used in soft tissue reconstruction of upper and lower extremities. It was first used for lower limb reconstruction and then the clinical application was increased to include reconstruction of upper extremity, head and neck.