Distally Based Fasciocutaneous Flap from the Sural Region

Donski, P; Fogdestam, Ingemar

doi:10.3109/02844318309013118

Cited by 212 publications

(46 citation statements)

References 14 publications

(9 reference statements)

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“…In 1983, Donski and Fogdestam first described a distal perforator-based sural fasciocutaneous flap for heel coverage. 11 The flap was supplied by a vascular bundle, with the perforating branches from the posterolateral septum as the major pedicle. Based on anatomic studies, Nakajima et al proposed the concepts of the neuro-adipo-fascial pedicled fasciocutaneous flap (NAF-flap), veno-adipo-fascial pedicled fasciocutaneous flap (VAF-flap), and veno-neuro-adipo-fascial pedicled fasciocutaneous flap (VNAF-flap).…”

Section: Discussionmentioning

confidence: 99%

Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle

Chang¹,

Zhang²,

Yu³

et al. 2004

Microsurgery

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The distally based sural fasciocutaneous flap has been used widely for reconstruction of foot and ankle soft-tissue defects. Here we report on a series of cases of foot and ankle reconstruction with a modified distally based sural flap. The vascular pedicle of the flap includes an axial perforator branch of the peroneal artery and two concomitant veins. This modified distally based perforator flap, measuring around 17 x 6 cm to 30 x 10 cm in size, was transferred for coverage of foot and ankle soft-tissue defects in 7 cases. All flaps survived completely. Neither arterial ischemia nor venous congestion was noted. As compared to other distally based sural flaps with neuro-veno-adipo-fascial pedicles, this modified sural flap with a thin perforator pedicle is easily rotated. The flap can obtain abundant blood supply through both axial perforator and longitudinal chain-linked vascular plexuses, and does not have the venous reflow problem. In conclusion, the invention of this perforator fasciocutaneous flap provides a valuable tool for repair of foot and ankle soft-tissue defects.

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Section: Discussionmentioning

confidence: 99%

Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle

Chang¹,

Zhang²,

Yu³

et al. 2004

Microsurgery

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show abstract

“…The calf fasciocutaneous flap was first reported by Ponten 18 in 1981, and the distally based sural fasciocutaneous flap was first introduced by Donski and Fogdestam 19 in 1983. Since then, the vasculature of the calf and sural region of the posterior lower leg has been extensively investigated.…”

Section: Discussionmentioning

confidence: 99%

Distally based sural fasciomyocutaneous flap: Anatomic study and modified technique for complicated wounds of the lower third leg and weight bearing heel

Chang

Zhang

et al. 2008

Microsurgery

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The reconstruction of the distal third leg and weight-bearing heel, especially when complicated with infection and/or dead space, remains a challenge in reconstructive surgery. The distally based sural neurofasciomyocutaneous flap has been proved a valuable tool in repair of the soft tissue defects of those areas. In this report, we present the results of the anatomical study on vascular communication between the suprafascial sural neurovascular axis and the deep gastrocnemius muscle and a modified technique in clinical applications for reconstruction of the soft tissue defects in the distal lower leg and heel. Six lower limbs of fresh cadavers were injected with red gelatin and dissected. A constant vascular connection with average four musculo-fasciocutaneous perforators with diameter 0.2-0.5 mm was identified in the overlapping area between the suprafascial sural neurovascular axis and the deep gastrocnemius muscle. Based on these findings, a modified distally based sural neurofasciomyocutaneous flap including the distal gastrocnemius muscle component was designed and used for repairs of the soft tissue defects in the distal lower limb and plantar heel pad in six patients. The blood supplies of flaps comprised either the peroneal perforator and adipofascial pedicle or the peroneal perforator only. The average size of the fasciocutaneous flap was 51 cm(2), and the muscle component 17.7 cm(2). All flaps survived uneventfully. Our results suggest that this technical modification could provide wider range for applications of the distally based sural neurofasciomyocutaneous flap in repair of the soft tissue defects of the lower extremity and heel.

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“…Local muscle flaps over the distal calf region are too small for reconstructing large tissue losses. Skin flaps with random blood vessels are unreliable because of the necessary pedicle width to flap length ratio (1,3). Therefore the method of choice for larger reconstructions are free flaps (4).…”

Section: Discussionmentioning

confidence: 99%

“…In 1983, Donski and Fogdestam performed a sural flap procedure without knowing the exact vascularization (1). The conception of the fasciocutaneous flap based on a single perforator artery from peroneal artery or the posterior tibial artery was developed in the mid-80's (5).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Reverse Flow Sural Flap in the Treatment of the Soft Tissue Defects, Distally Part of the Leg - A Preliminary Report

Kulesza

Podlewski

Wasylewski

2009

Polish Journal of Surgery

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Distally Based Fasciocutaneous Flap from the Sural Region

Cited by 212 publications

References 14 publications

Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle

Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle

Distally based sural fasciomyocutaneous flap: Anatomic study and modified technique for complicated wounds of the lower third leg and weight bearing heel

The Reverse Flow Sural Flap in the Treatment of the Soft Tissue Defects, Distally Part of the Leg - A Preliminary Report

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