Outcomes of Single Stage Phalloplasty by Pedicled Anterolateral Thigh Flap versus Radial Forearm Free Flap in Gender Confirming Surgery

2018 ◽  
Vol 199 (1) ◽  
pp. 206-214 ◽  
Author(s):  
Mona Ascha ◽  
Jonathan P. Massie ◽  
Shane D. Morrison ◽  
Curtis N. Crane ◽  
Mang L. Chen
2020 ◽  
Vol 47 (4) ◽  
pp. 354-359 ◽  
Author(s):  
Chad M. Teven ◽  
Jason W. Yu ◽  
Lee C. Zhao ◽  
Jamie P. Levine

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap that has been used successfully in the reconstruction of defects across the body. In specific cases, it may prove superior to more commonly used options (e.g., anterolateral thigh flap and radial forearm free flap). Historically, a disadvantage of the MSAP flap is the relatively small surface area it provides for reconstruction. We recently encountered a patient with extensive pelvic injuries from prior trauma resulting in significant scarring and contracture of the groin, tethering of the penis, and loss of the scrotum and one testicle. The patient was unable to achieve erection from tethering and his remaining testicle had been buried in the thigh. In considering the reconstructive options, he was not a suitable candidate for a thigh-based or forearmbased flap. An extended MSAP flap measuring 25 cm×10 cm was used for resurfacing of the groin and pelvis as well as for the formation of a neoscrotum. This report is the first to document an MSAP flap utilized for simultaneous groin resurfacing and scrotoplasty. Additionally, the dimensions of this flap make it the largest recorded MSAP flap to date.


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