The relatively new medial sural artery perforator flap is increasingly being used for reconstruction. However, muscle necrosis of the medial head of gastrocnemius after MSAP flap harvest is a previously unnoticed early complication of the donor site. We present two cases of MSAP flap reconstruction that developed this early complication.
Keywords: MSAP flap; early donor site complication; medial head of gastrocnemius.