AUTHOR=Xu Xiang , Wang Cheng , Chen Zhenbing , Li Jin 

TITLE=Medial plantar artery perforator (MPAP) flap is an ideal option for reconstruction of complex soft tissue defect in the finger: Clinical experience from 11 cases

JOURNAL=Frontiers in Surgery

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.934173

DOI=10.3389/fsurg.2022.934173

ISSN=2296-875X

ABSTRACT=Introduction
Defects of sSoft tissues defects of  in the fingers are common in reconstructive plastic surgery, and reconstruction of the defects remains challenging for plastic surgeons.and remain challenging for reconstructive plastic surgery. In our study, we reported our experience in finger reconstruction with medial plantar artery perforator (MPAP) flap, especially using lobulated MPAP flap for the complex multi-finger soft defect.
Patients and methods
From April 2012 to October 2018, 11 patients (9 males and 2 females) with an average age of 44 years old (ranging from 11 to 58) received finger reconstruction with free MPAP flap. In total, 14 flaps (8 single-lobulated flaps and 3 two-lobulated flaps) were raised from the ipsilateral or contralateral instep area. Trauma and scar contracture caused the hand soft tissue loss in all cases.
Results
The sizes of the flaps ranged from between 2*3 and to 5*7.5 cm2. All flaps survived intact with no complications. One donor site was closed primarily, and other donor sites were covered with full-thickness skin graft. The mean follow-up time was 6 months (ranging from 3 to 8 months). During the follow-up period, the patients' finger function improved, and they were satisfied with the appearance without traces of flap plastic surgery. 
Conclusion
The MPAP flap is a reliable and acceptable option for reconstruction of complex soft-tissue defects in the finger. Depending on the two branches of the medial plantar artery, the use of lobulated MPAP flap is promising in the treatment of multi-finger soft tissue defects.