Clinical Study of the Lateral Supramalleolar Flap in the Soft Tissue Reconstruction around the Ankle Region

Abstract

Objective The purpose of this study is to present the efficiency of the lateral supramalleolar flap which is a very useful and yet underutilized in the soft tissue reconstruction of the regions extending from the distal leg, ankle, and foot. Methods Over a period of 3 years, 20 flaps were used in the reconstruction of soft tissue defects in the region extending from the distal leg, ankle, and foot. The location of the defects, the etiology, possible alternative flaps, outcome, and the complications were studied and presented. Results The follow-up period of the cases was from 1 month to 18 months after surgery. Seventeen flaps survived and three were lost. All the three lost flaps were those used over the tendocalcaneal region. The lost flaps were later replaced with split skin graft after the wound was debrided and was later covered with granulation tissue. Conclusion The lateral supramalleolar flap is a very useful flap in the regional soft tissue reconstruction around the ankle except in the tendocalcaneal region.

Lateral supramalleolar flap: Is it based on perforator of peroneal / anterior tibial artery; A cross-sectional study at tertiary care centre

“…Dubreil Chambradel [ 8 ] found the peroneal artery perforator absent in 10 out of 165 cadaveric dissections. Relevant literature [ 9 , [11] , [12] , [13] , [14] , [23] , [24] , [25] , [26] , [27] ] shows a persistent and constant presence of perforator of the peroneal artery but our experience is different. We detected 19 cases out of 49 in which the peroneal artery perforator was replaced with inferolateral collateral perforator from anterolateral malleolar artery from the anterior tibial artery.…”

“…The complication rate of flap necrosis and venous congestion was higher in older series [ 24 , 25 ] ranging from 5% to 20%. Recent series [ 26 , 27 ] show a relatively lesser rate of complications in terms of flap necrosis, venous congestion, and infections.…”

“Repair and Flap technique”: A Retrospective Analysis of Single Stage Reconstruction Method for Treatment of Chronic Open Achilles Tendon Defect with Proximal Turndown Flap and Reverse Sural Flap

“…The treatment of chronic open wound includes debridement of the wound and achieve a healthy granulation tissue and cover with split thickness skin graft [9]. The other reconstruction options following debridement includes use of the local pedicle flap and microvascular flap [7,[10][11][12][13] . We have compared the outcomes of current study with various published studies in which reverse sural flap was used for reconstruction (Table 2) [1,10,[17][18][19][20][21].…”

“…Reconstruction of tendoachilles and coverage with local pedicle flaps has been well described technique. The various methods of reconstruction includes fascia lata graft, turned down flaps from the proximal segment of the Achilles tendon and coverage with reverse sural flap, lateral supra-malleolar flap and perforator based propeller flaps [1,[13][14][15]20]. Among the local pedicle flaps, the reverse sural flap has evolved as the important flap owing to its versatility, ease of elevation and application [16].…”

A Single-Center Surgical Experience With the Reverse Sural Artery Flap as a Reliable Solution for Lower Leg Soft Tissue Defects, With Minimum Two-Year Follow-Up

“…Immobilization and difficult positioning are avoided unlike the cross-leg flaps [ 7 ]. The lateral supra malleolar flap despite its technical ease has fewer indication options sizewise and results in a larger insensate area of the foot [ 8 ]. Therefore, RSAF is popular among surgeons for its reliability, relative technical ease, lack of dependency on microsurgery, preservation of the major arterial supply to the lower limb, and relative economic liability to the patient and the health care infrastructure [ 2 , 3 ].…”