Repeated reverse sural fasciocutaneous flap is an effective surgical strategy for repairing long segmental soft tissue defects of the tibia

Abstract

ObjectiveThis study was performed to introduce our surgical strategy and experience in applying a repeated reverse sural fasciocutaneous flap (RSFF) to repair large areas of tibial exposure.MethodsDuring a 3-year period, 10 patients with a large area of tibial exposure and intact posterior skin and soft tissue after trauma were treated in our hospital using a repeated RSFF. First, most of the area of proximal tibial exposure was covered by an RSFF. Three weeks later, another smaller RSFF was designed from the original flap and rotated to repair the remaining exposed area of the tibial wound.ResultsAll 10 patients’ wounds were completely healed after 2 to 4 operations. The wounds had healed well after 6 months. The patients were satisfied in terms of both appearance and function.ConclusionThe repeated RSFF is a good treatment strategy for patients with large areas of tibial exposure with intact posterior skin and soft tissue.

One Stage versus Two Stages Distally Based Reverse Sural Flap for Leg and Foot Reconstruction: A Meta-Analysis Study

“…Our results were supported by study of Cui et al [13] as they reported that ten patients were treated with the same surgical plan for wound repair. The patients comprised seven males and three females ranging in age from 18 to 65 years.…”

“…In a study conducted by Cui et al [13] , the duration of tibial exposure ranged from 5 to 20 days [mean, 14 ± 7.3 days]. After reverse sural fasciocutaneous flap [RSFF] surgery, local skin flap necrosis occurred in two patients, and all wounds in the remaining eight patients healed.…”

“…According to Cui et al [13] , all 10 patients were followed for 6 months, and the wounds healed without infection or ulceration and with good limb function. All patients returned to their previous occupation and daily activities.…”

“…Age m\f Shtutin et al [12] Retrospective 21 39.6 19\2 Rihan et al [10] comparative study 20 45 14\6 Sahu et al [11] Retrospective 12 34.2 9\3 Saaiq and Zimri [7] comparative study 34 28.82 27\7 Cui et al [13] Retrospective 10 41.5 7\3 Raza et al [14] Retrospective 87 36.7 74\13 Maazil [15] Retrospective 22 17 16\6 Rihan et al [10] Diabetic neuropathy and ischemia The heel in 15 cases [75%], the ankle in 3 cases [15%] and the distal third leg in 2 cases [10%].…”

“…Maazil [15] trauma in 15 patients, post-surgical excision in 2 patients and unstable scar and burn in 5 patients Distal leg, Ankle and tendo-achilles, Sole of foot, Dorsum of foot, Heal 36 [10] Single staged 10 2 2 2 Two staged 10 0 1 1 Sahu et al [11] Single staged 6 0 0 0 3 Two staged 6 0 0 0 Saaiq and Zimri [7] Single staged 17 13 0 0 14.61±1.93 Two staged 17 1 0 0 14.61±1.93 Cui et al [13] Single staged 10 0 0 0 Two staged 10 0 0 0 Raza et al [14] Single staged 46 0 0 0 43.1 ±3.6 Two staged 41 0 0 0 27.9 ±2.1 Maazil [15] Single staged 15 0 0 0 Two staged 7 0 0 0 [11] 6 0 6 0 --Saaiq and Zimri [7] 17 0 17 0 --Cui et al [13] 10 0 10 0 --Raza et al [14] 46 0 41 0 -- [12] 9 3 12 2 2.000 0.417 to 9.581 Rihan et al [10] 10 3 10 0 7.000 0.408 to 120.164 Sahu et al [11] 6 0 6 0 --Saaiq and Zimri [7] 17 0 17 0 --Cui et al [13] 10 0 10 0 --Raza et al [14] 46 0 41 0 -- [12] 9 2 12 0 6.5 0.350 to 120.803 Rihan et al [10] 10 0 10 0 -Sahu et al [11] 6 0 6 0 -Saaiq and Zimri [7] 17 6 17 0 13 0.789 to 214.062 Cui et al [13] 10 0 10 0 -Raza et al [ [11] 6 3 6 1 3 0.423 to 21.298 Saaiq and Zimri [7] 17 3 17 0 7 0.389 to 125.994 Cui et al [13] 10 0 10 0 --Raza et al [14] 46 12 41 3 3.565 1.081 to 11.755 Maazil [15] 15 0 7 0 -- [12] 9 1 12 0 3.900 0.177 to 85.940 Rihan et al [10] 10 3 10 1 3.000 0.372 to 24.172 Sahu et al [11] 6 0 6 0 --Saaiq and Zimri [7] 17 3 17 1 3.000 0.346 to 26.041 Cui et al [13] 10 2 10 0 5.000 0.270 to 92.627 Raza et al [14] 46 0 41 0 -- [12] 9 0 12 0 --Rihan et al …”