Supercharged reverse-flow sural flap: A new modification increasing the reliability of the flap

Tan, Önder; Atik, Bekir; Bekerecioğlu, Mehmet

doi:10.1002/micr.20072

Cited by 88 publications

(67 citation statements)

References 18 publications

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“…Other authors do not tunnel the flap under the skin due to fear of compression of the fatty pedicle against the skin especially in the postoperative phase when more swelling develops [13]. Other modifications to increase size include delaying [14][15][16] a wider than usual pedicle [17], supercharging [18], and harvesting a midline cuff of the gastrocnemius muscle with the flap [19]. Techniques without proximal extension of the flap such modifications included exteriorizing the pedicle [20], mobilizing the peroneal perforator in the intermuscular septum [6], and cross-leg sural flap [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison between Peroneus Brevis Flap and Reverse Sural Artery Flap for Coverage of Lower One-Third Leg Defects

Thammannagowda

Ashish

Mudukappa

et al. 2014

ISRN Plastic Surgery

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Posttraumatic wounds and soft tissue defects in the distal third of the leg and ankle remain a challenge. Defects at this site will often require flap cover. Free flap is ideal for these defects and gives good results but with its own limitations. The reverse sural artery flap (RSAF) and distal peroneus brevis flap (DPBF) have gained popularity for lower third leg defects among surgeons. We did a retrospective study on 64 patients admitted between 2011 and 2013 with posttraumatic moderate size defects of lower onethird leg who underwent RSAFs and DPBFs. These patients were followed up in the immediate and late postoperative period for complications and outcome assessment. The average surface area covered by DPBF was 27 cm 2 and by RSAF was 38 cm 2 . Both flaps gave a good functional outcome. DPBF has better aesthetic appearance at donor site and recipient site, with the advantages of ease of surgery, speedy recovery, less hospital stay, and no donor site morbidity; DPBFs appear to be a preferred choice for moderate size lower third leg defects. RSAFs should be chosen over DPBFs for defects in medial malleolus and larger size defects.

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Section: Discussionmentioning

confidence: 99%

Comparison between Peroneus Brevis Flap and Reverse Sural Artery Flap for Coverage of Lower One-Third Leg Defects

Thammannagowda

Ashish

Mudukappa

et al. 2014

ISRN Plastic Surgery

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“…79 Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein to any vein in the area of the recipient defect site. By draining the proximal lesser saphenous vein stump, this technique allows the flap to drain in a physiologic direction.…”

Section: The Supercharged Sural Flapmentioning

confidence: 99%

The Distally Based Sural Flap

Follmar

Baccarani

Baumeister

et al. 2007

Plastic and Reconstructive Surgery

145

130

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Over the past decade, the distally based sural flap has become increasingly used in reconstruction of the foot and lower leg. The rise in popularity of this flap has been paralleled by an increase in the number of cases, innovations, and technical refinements reported in the medical literature. This review summarizes the 79 publications in the English language literature on the subject of the distally based sural flap. The anatomical studies are summarized in a unified description of the relevant flap anatomy. The flap's indications and composition and a variety of modifications are described. Technical aspects are discussed and clinical insight to minimize complications is provided. In conclusion, the distally based sural flap offers an alternative to free tissue transfer for reconstruction of the lower extremity.

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“…Venous anastomosis between the proximal end of the sural flap vein and a subcutaneous vein found locally in the region of the former defect as a simple modification to minimize complications is also suggested by Dragu et al and others. 25,26 Loonen et al evaluated the anatomical basis for the venous outflow of the sural flap, and they recommended a 3.5 cm wide pedicle located on both sides of the saphenous vein for a safe venous drainage to include the concomitant veins. 27 Baumeister et al 12 believed that the sural artery flap was susceptible to failure if any pressure was put on the pedicle, and a skin tail overlying the pedicle seemed to increase safety and offer less pressure on the pedicle.…”

Section: Discussionmentioning

confidence: 99%

Using the Pedicle Flap for Taking Pressure off the Pedicle in Distally Based Skin Flaps

Zhao

Wang

Jiang

2013

J reconstr Microsurg

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This report describes our experience using the pedicle flap for taking pressure off the pedicle in distally based skin flaps. Between July 2007 and March 2010, distally based skin flaps were used to treat 34 patients with soft tissue defects in the lower leg, ankle, and foot. A pedicle flap was used to take pressure off the pedicle in all of these flaps. There were 21 men and 13 women with a mean age at surgery of 47 years (range, 21 to 67 years). The sizes of the soft tissue defects varied from 5.0 cm × 2.0 cm to 17.0 cm × 10.0 cm. The pedicle flap sizes varied from 1.0 cm × 1.0 cm to 5.0 cm × 3.5 cm. All flaps survived completely except three, which suffered a marginal partial flap necrosis due to venous congestion. These flaps healed by secondary intention after changing the dressing. Using the pedicle flap takes pressure off the pedicle and facilitates primary closure after transposition of the distally based skin flaps, which is a simple and effective method to prevent complications of these flaps.

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Supercharged reverse-flow sural flap: A new modification increasing the reliability of the flap

Cited by 88 publications

References 18 publications

Comparison between Peroneus Brevis Flap and Reverse Sural Artery Flap for Coverage of Lower One-Third Leg Defects

Comparison between Peroneus Brevis Flap and Reverse Sural Artery Flap for Coverage of Lower One-Third Leg Defects

The Distally Based Sural Flap

Using the Pedicle Flap for Taking Pressure off the Pedicle in Distally Based Skin Flaps

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