The Reverse Sural Artery Flap

Johnson, Lance; Liette, Michael D.; Green, Christopher; Rodriguez, Pedro; Masadeh, Suhail

doi:10.1016/j.cpm.2020.05.004

Cited by 7 publications

(5 citation statements)

References 44 publications

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“…Tunneling is generally not preferred because of the risk of compression and increased flap necrosis. 8 Tunnelling was avoided in all the cases in our study.…”

Section: Discussionmentioning

confidence: 70%

Comparison of Reverse Sural Artery Fasciocutaneous Flap in Soft Tissue Reconstruction Between above Ankle and Below Ankle Defect

Pandey

Bidary

2022

Kathmandu Univ. Med. J.

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Background Fasciocutaneous reverse sural artery flap is a popular option to treat soft tissue defects in the distal leg, ankle, and foot region. Objective To compare the results of sural artery flap reconstruction between the above ankle and below ankle soft tissue defect. Method It was a retrospective study of sural flap reconstruction of varied etiology for the defect grouped as above ankle and below ankle operated over a period of five years. Flap and graft take-up, rate of primary healing, margin necrosis, and complications were the assessed outcome variables. Result There were a total of 37 patients, 17 cases of the above ankle and 20 cases of below ankle sural flap reconstruction analyzed in the study. Road traffic accident was the most common cause and the mean size of the defect was 40.70 cm2. The overall flap take-up rate was 94.6%, partial margin necrosis was in 6 patients, and > 50% flap necrosis was in 2 cases. The rate of primary healing, margin necrosis and mean healing time were 17 (100%) vs 12 (60%), 0 vs 8 cases (6 margin necrosis and 2 cases of > 50% of flap necrosis), and 20.04 days vs 22.50 days respectively in the above ankle and below ankle flap reconstruction groups. These differences were statistically significant. Conclusion Fasciocutaneous reverse sural artery flap is an excellent choice for reconstruction of the defect at the distal leg and around the ankle region with a high success rate. Below ankle flap reconstruction showed a higher rate of margin necrosis, longer healing time, and less rate of primary healing as compared to the above ankle group.

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“…Tunneling is generally not preferred because of the risk of compression and increased flap necrosis. 8 Tunnelling was avoided in all the cases in our study.…”

Section: Discussionmentioning

confidence: 70%

Comparison of Reverse Sural Artery Fasciocutaneous Flap in Soft Tissue Reconstruction Between above Ankle and Below Ankle Defect

Pandey

Bidary

2022

Kathmandu Univ. Med. J.

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“…Treating patients with foot defects presents several challenges due to the limited availability of mobile skin. 4 5 6 The reverse sural flap has been commonly used as a workhorse flap to cover foot defects; however, venous congestion and partial flap necrosis are some of its associated complications. 7 8 As per our experience, the reverse sural flap needs conditioning such as delay, thereby increasing the number of stages and operative costs.…”

Section: Discussionmentioning

confidence: 99%

Empirical Evidence on the Reliability of Lateral Supramalleolar Flap over Reverse Sural Flap for Local Soft Tissue Coverage of Dorsum of the Foot and Ankle Defects

Jaiswal

Gupta

Goil

et al. 2023

Indian J Plast Surg

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Background Soft tissue coverage of the distal foot and ankle region has been an area of debate due to the paucity of local flap options. To provide empirical evidence on the reliability of an underreported local alternative for foot and ankle defects, we aim to compare the lateral supramalleolar flap (LSMF) to the reverse sural flap (RSF). Methods During 2016–2019, 48 patients were divided randomly into two equal groups, LSMF and RSF groups respectively. The patients' demographic, surgical, and clinical outcome details were recorded and analyzed. Results Flap necrosis was found in five patients in the group treated with RSF and none in the LSMF group. The mean total number of stages in RSF group was significantly higher than in LSMF group (p < 0.05). The mean operative time for patients in LSMF group was 85.8 ± 18.5 and 54.2 ± 11.2 in RSF group (p < 0.05). Five patients in the RSF group needed additional procedures following flap complications. Nine patients in the LSMF group reported satisfaction outcomes to be “excellent,” five patients reported “good” whereas, in the RSF group, 14 patients reported “excellent,” 5 reported “good,” 3 reported “fair,” and 2 reported “poor” outcomes. Compared to the RSF (46.4 ± 4.3) group, the LSMF group had significantly better foot function indices (34.03 ± 3.9). Conclusion The lateral supramalleolar flap for foot and ankle defects offers better results, reduced complications as well a lesser number of stages and secondary procedures over the traditionally used reverse sural flap.

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“…15 The RSF is a neurofascioucutaenous flap that has proven useful in the coverage of soft tissue defects in the distal 1/3rd of the lower leg, including the ankle and posterior heel. 16 The fasciocutaneous flap technique was introduced in 1981 for lower leg tissue reconstruction, and the technique was expanded on in 1992 with the inclusion of the sural nerve. 15,17 A rotational component was then added in 2004, allowing for easy 180-degree rotation.…”

Section: Historymentioning

confidence: 99%

Simplified soft tissue coverage of the distal lower extremity: The reverse sural flap

Puneky,

Batchler,

Kollapaneni

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Summary: Soft tissue defects involving the distal lower extremity present challenging problems for orthopaedic surgeons to manage. Historically, wounds not amenable to primary closure have necessitated assistance from multidisciplinary teams using plastic surgeons to obtain adequate soft tissue coverage through rotational flap or free tissue transfer procedures. Techniques related to soft tissue rearrangement and local rotational flap coverage have advanced over the years with a growing knowledge of local anatomy and vasculature. The reverse sural flap may be performed to cover soft tissue defects within 10 cm of the foot or ankle region, negating the need for microvascular intervention. The simplistic nature of the reverse sural flap is appealing to orthopaedic surgeons as a means to provide timely patient care without additional support because it does not require microvasculature work or the need for intraoperative microscopes and has been popularized among orthopaedic trauma surgeons as a necessary tool to possess. Here, we discuss the reverse sural flap to include history, relevant anatomy, clinical indications, and a description of the technique for application.

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The Reverse Sural Artery Flap

Cited by 7 publications

References 44 publications

Comparison of Reverse Sural Artery Fasciocutaneous Flap in Soft Tissue Reconstruction Between above Ankle and Below Ankle Defect

Comparison of Reverse Sural Artery Fasciocutaneous Flap in Soft Tissue Reconstruction Between above Ankle and Below Ankle Defect

Empirical Evidence on the Reliability of Lateral Supramalleolar Flap over Reverse Sural Flap for Local Soft Tissue Coverage of Dorsum of the Foot and Ankle Defects

Simplified soft tissue coverage of the distal lower extremity: The reverse sural flap

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