Heel Coverage Using a Distally Based Sural Artery Fasciocutaneous Cross-leg Flap: Report of a Small Series

Basile, Attilio; Stopponi, Marcello; Loreti, Andrea; Simeonibus, Angelo Ugo Minniti De

doi:10.1053/j.jfas.2007.12.005

Cited by 26 publications

(28 citation statements)

References 16 publications

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“…[20] Reconstruction of lower leg defects is difficult for plastic surgeons due to few available local flap options in this area. [1,13,[19][20][21] One of the most common causes of complex lower leg and foot defect in industrialized society is high voltage (>1000 volts) electrical injury. [22][23][24] In high voltage electrical burns, the electrical source contact area (entry and exit points of body) determines the severity of the lesion.…”

Section: Discussionmentioning

confidence: 99%

“…[14] Posterior crural based local flaps can be used in the lower leg defect repairs when microsurgery is not considered. [13,25] One of the most useful crural based flaps is DBSF. It has been used for the reconstruction of the distal portion of lower leg and feet defects since its original description by Masquelet et al [26] Basically, DBSF's blood supply comes from peroneal perforators and small extrinsic vessels around the sural nerve and some branches of the lesser saphenous vein.…”

Section: Discussionmentioning

confidence: 99%

“…[13,14,16,18] Since cross-leg flaps were introduced by Hamilton in 1854, a lot of techniques have been developed and introduced. [18,28,29] DBSF also can be used as cross-leg fashion due to its reliable pedicle length.…”

Section: Discussionmentioning

confidence: 99%

“…The size of DBSF was determined based on what was needed to cover the defect on the cross leg. Pedicle base of the DBSF was preserved 5-7 cm above the lateral malleolus and the base width of the flap was between medial and lateral malleoli as described in the literature [6,13,19] (Fig. 3).…”

Section: First Operationmentioning

confidence: 99%

“…In this instance, the problem can be overcomed by using cross-leg flaps. [13][14][15][16] Additionally, after a free flap failure, cross-leg flaps can help repair any remaining defects. [17] One of the most useful alternatives to free tissue transfers in the lower leg is the cross-leg distally based sural flap (DBSF).…”

mentioning

confidence: 99%

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An alternative method to free flap for distal leg and foot defects due to electrical burn injury: Distally Based Cross-Leg Sural Flap

Eser

Kesiktaş

Gencel

et al. 2015

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: High voltage electrical injuries can cause devastating results especially in distal extremities. Although free flaps are the golden standards for the reconstruction of these defects, sometimes local flap alternatives are more useful. One of the most favorable local flap is distally based sural flap (DBSF), which can be used in cross-leg fashion when ipsilateral extremity is affected by a high voltage electrical injury. The purpose of this study was to evaluate long term results of eleven patients who underwent a reconstruction to the lower extremity with cross-leg DBSF due to high voltage electrical burn injury between the years of 2003-2013.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: First Operationmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

An alternative method to free flap for distal leg and foot defects due to electrical burn injury: Distally Based Cross-Leg Sural Flap

Eser

Kesiktaş

Gencel

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Technique du «cross-leg»

Gasnier

2012

Réparations Tissulaires À La Jambe

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Complete avulsion of the heel pad with talar and calcaneal fracture: salvage with multiple K-wire anchorage, internal fixation and free ALT flap

Herold

Kamin

Bota

et al. 2022

Arch Orthop Trauma Surg

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Background Degloving of the sole of the foot is a rare and serious injury because the heel pad cannot be replaced by similar tissue. The management is challenging and only a few cases have been reported with different treatment regimens. Methods Here, we report on a 46-year-old female patient with complex foot trauma consisting of complete avulsion of the heel pad at the hindfoot and a soft tissue defect at the posterior aspect of the heel accompanied by rupture of the anterior tibial tendon and fractures of the talus, calcaneus and midfoot. The sole of the foot was fixed to the calcaneus with multiple temporary Kirschner wires and moist wound dressings. The anterior tibial tendon was sutured. The soft tissue defect at the posterior heel was treated with a free anterolateral thigh flap. The fractures were fixed in staged procedures. Results At 2-year follow-up, the patient had a durable soft tissue cover over the heel with full sensation over the sole and a pliable flap over the posterior aspect of the heel. The patient was able to fully bear weight and was pain free during her daily activities in comfortable, custom shoes. All fractures had healed, the talar neck fracture after one revision and bone grafting. The foot was plantigrade and stable with preserved painless but limited range of motion at the ankle, subtalar and mid-tarsal joints. Conclusion The unique tissue at the sole of the foot can be salvaged even in cases of full degloving at the hindfoot with the simple method of anchorage with multiple temporary K-wires. Traumatic defects of the vulnerable skin at the posterior aspect of the heel requires durable coverage with free flap coverage. With staged treatment of all bone and soft tissue injuries, a favorable result can be obtained even in case of a complex foot trauma.

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Heel Coverage Using a Distally Based Sural Artery Fasciocutaneous Cross-leg Flap: Report of a Small Series

Cited by 26 publications

References 16 publications

An alternative method to free flap for distal leg and foot defects due to electrical burn injury: Distally Based Cross-Leg Sural Flap

An alternative method to free flap for distal leg and foot defects due to electrical burn injury: Distally Based Cross-Leg Sural Flap

Technique du «cross-leg»

Complete avulsion of the heel pad with talar and calcaneal fracture: salvage with multiple K-wire anchorage, internal fixation and free ALT flap

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