Vol. 5, Issue 2 (2019)
Study of versatility of reverse sural fasciocutaneous flap for reconstruction of lower third leg defect
Author(s): Dr. Shyam Kumar Satyapal
Abstract: Soft-tissue defects of the lower extremity usually result from trauma, infection, vascular insufficiency, or surgery. The sural flap proved a considerable versatility at the level of the lower leg (from the knee to the ankle and heel) as well as for other anatomical regions. The most common usage of the flap is for the distal-third defects of the leg. Here, the reverse sural flap permits the soft tissue reconstruction without the need for microsurgery. It does not sacrifice any of the three major arteries to the distal extremity. Sparing the major artery, the relatively simple dissection and the low donor site morbidity are among the most important advantages of using this flap. This study is a retrospective review of the sural fasciocutaneous flaps carried out in 14 patients): 11 men and 3 women with an average age of 41 years (ages 16-61) and a postoperative follow-up between 1 years and 2 years. Most of the patients had sustained road traffic accident. Nine (9) of the defects were over the lower 1/3rd leg, three (3) of the defects were around the medial malleoli, One(1) over the anterior ankle, and 2 over lateral malleoli. There was an underlying bone, fracture, implant or tendon exposed in 9 patients. 3 of this patients underwent standard reverse sural island flap and rest 11 patient underwent reverse sural fasciocutaneous flap. The size of the defects for island flaps ranged from 5x5cm to 9x8cm. The length of sural fasciocutaneous flaps ranged from 7 to 25cm from the tip of lateral malleolus. All the defects were covered successfully, without major complications. In our conclusion, reverse sural artery fasciocutaneous flap distally based on peroneal perforators is a good option to cover the soft tissue defect of distal third leg, ankle, heel and dorsum of the hind foot. The present study was planned in the Department of Plastic Surgery, Pulse Emergency Hospital, Patna, Bihar. Total 14 cases of the operated from June 2016 to Dec 2017 were included in the present study.