Distally based reverse sural artery flap as an interpolation flap

Abstract

Background: Coverage of soft tissue defects of the foot and ankle has imposed a challenging situation to the plastic surgeon. Some patients have contraindications for microsurgery, thus limiting the options for local tissue transfer. The Reverse sural artery flap is frequently used for reconstruction of distal third leg, ankle, and heel. The major disadvantage of RSA flap is compression of pedicle within subcutaneous tunnel leading to venous congestion and distal flap necrosis. To overcome this problem, we describe an interpolation flap technique in which subcutaneous tunneling of neurovascular structures is avoided. Methods: 13 cases of distally based RSA flaps as interpolation flap were performed for soft tissue defects in dorsum of foot, heel pad, malleoli, and TA region during the period 2014 to 2016. Results: With this procedure no flap loss was observed in this series and only a few minor complications occurred. The pedicle is divided in a second stage operation. Conclusions: We conclude that transferring the flap in 2 stages without use of tunnel improves the reliability of flap and decreases the chances of necrosis.

Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap

“…In this study, a reverse sural artery flap was used, which has been proven to be clinically effective in treating defects in the distal lower extremities, such as the tibia ankle and heel defects [23,24]. Similar to the results of this study, several studies have shown good results with the procedure in the lower limbs [25][26][27]. This procedure is a myofascial skin flap based on the sural artery network; therefore, unlike the free flap, it does not require microsurgery using a microscope, making the procedure simple.…”