Novel use of Pedicled Medial Sural Artery Perforator flap for Post Burn Knee Contractures

Background: Postburn flexion contractures of the knee may arise even with adequate treatment of the burn injury. Pedicled medial sural artery perforator (MSAP) flap has been described for the reconstruction of defects of the knee and proximal third of the leg. Its use in the management of postburn contracture release is sparse. We are presenting the use of a medial sural artery pedicled flap for the reconstruction following postburn knee contracture release. Materials and Methods: This study included six patients with postburn unstable scars and a mild degree of knee contractures who underwent release of the contracture and coverage using MSAP pedicled flap. The results in terms of flap size, recurrence, complications, functional outcome, and cosmesis were assessed. Results: The flap size ranged from 7 cm x 6 cm to 13 cm x 7 cm with a mean pedicle length of 9.41 cm. All six flaps survived without any complications with a satisfactory outcome. The patients were followed up for 6-18 months. There was no recurrence of contracture without any restriction of knee joint mobility. Conclusion: MSAP flap is a reliable flap and should be considered for the management of postburn knee contracture of grade 2 and grade 3 contractures, as it provides optimum and ideal coverage with fewer chances of recurrence.