OBJECTIVE: To present the experience with sural flap in reconstruction of soft tissue defects of lower leg, ankle and foot.
SETTINGS: Private Practice (Aesthetic Plastic Surgery), Rawalpindi, Pakistan; from June 2005 to February 2008.
PATIENTS AND METHODS: All the patients preceding with wound on foot, ankle or lower leg region were included in the study. Distally based sural neurocutaneous flap was used to cover the defects. The flap was marked in the prone position and it was outlined on the posterior lower 2/3 of leg according to the size and location of the defect. The flap was raised from distal to proximal. Donor site was closed primarily in its proximal part only. The remaining defect was reduced to a smaller size and covered with the split-thickness skin graft.
RESULTS: Distally based sural flap was used in 10 cases for soft tissue coverage. Mean age of the patients was 40.2 years. The flap size varied from 12 × 4 cm to 20 × 6 cm. Average length of the flap was 15.6 cm, and width was 5.3 cm. The flap survived in 90% of the patients. Partial flap loss (3 × 2 cm) was seen in one patient. Partial wound dehiscence was seen in 20% of the patients.
CONCLUSION: The reverse sural artery flap is a reliable option for the reconstruction of defects of lower leg, ankle and heel region.
Wounds, Sural Neurocutaneous flap, Sural artery flap, Sural Nerve, Split thickness skin graft.