Over the last decade, the sural flap has been popularized as a suitable alternative to free-tissue transfer for soft-tissue coverage of the lower extremity. However, flap failure rates may be increased especially if patients have certain risk factors, such as age over 40 years, peripheral artery disease, venous insufficiency, diabetes mellitus, and others. This article describes a sural flap delay procedure to avoid flap necrosis in this potentially "high-risk" patient population.
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