Versatility of Reverse Sural Artery Flap for Coverage of Heel and Proximal Foot Defects in Children

Abstract

Objective: The objective of the study was to determine the versatility of reverse sural artery flap in terms of its reliability and efficacy for reconstruction of soft-tissue defects of heel and proximal foot in children. Material and Methods: A total of 30 patients aged 5-13 years with ankle and foot defects admitted to the Plastic Surgery and Burn department at the Sheikh Zayed Hospital, Rahim Yar Khan from January 2018 to July 2020 were studied by designing a retrospective cross-sectional case series study. Results: Out of 30 flaps, 26 (86.7%) healed fully, whereas 4 (13.3%) complicated by partial necrosis requiring a secondary procedure. Nineteen (63.3%) patients had wheel spoke injuries, eight (26.6%) sustained degloving injury after a road traffic accident, and three (0.1%) patients were having a history of electric burn. In 22 patients an interpolated flap was used and in 8 cases an islanded flap. Donor sites were skin grafted in all patients. Two patients developed hypertrophic scarring at donor area. All patients showed good functional results, however flap remained insensate throughout the follow-up period that was minimum for 6 months. Conclusion: The reverse sural artery flap is versatile, reliable and a method of choice in reconstructing soft-tissue defects of the hind foot in children. This flap is easy to dissect, has robust blood supply and does not sacrifice any major blood vessel of the leg. Key Words: Reverse Sural Artery Flap, children, Ankle and Foot, Soft-tissue Defects, Wheel Spook Injury

Quantification and Further Refinement of Lateral Calcaneal Artery Flap for Complicated Heel Defect Reconstruction

“…The basic principle of plastic surgery is “replace like with like.” 1 Options for soft tissue coverage can be skin graft, loco-regional flap, and free tissue transfer. 2…”

“…1 Options for soft tissue coverage can be skin graft, loco-regional flap, and free tissue transfer. 2 There is always a search for new options to overcome these pitfalls. Grabb and Argent, in 1981, described the calcaneal artery flap, a viable option for soft tissue coverage of the posterior heel.…”