Reverse Sural Artery Flap; Ten Years Experience at a Tertiary Care Centre.

Abstract

Distally based Sural flap; distal leg, heel and foot defects; reconstruction of foot. Soft tissue management around the lower third of the leg and foot presents a considerable challenge to the reconstructive plastic surgeon. The options in this region are limited. A durable flap is the preferred option for coverage of such defects. This study was conducted over a period of 10 years to evaluate the efficacy of distally based Sural flap in coverage of the lower third of leg, ankle and foot defects. Material and Methods: A retrospective study was conducted in the department of Burns, Plastic, and Reconstructive surgery GMC Srinagar. The patients who underwent treatment from March-2008 to Feb-2018 were the subjects of study. Distally based sural fasciocutaneous flap was used for coverage in all cases and its survival, successful coverage of the defect and donor site morbidity studied. Results: Out of 100 flaps, 80 showed complete survival (80%). Partial flap loss (up to one third but less than half of the flap) was found in 3 patients (3%), marginal flap necrosis in 4 patients (4%), venous congestion developed in 5 patients (5%) and complete loss in 4 patients (4%) with extensive heel injury. Conclusions: The distally based sural flap is a versatile and reliable flap for the coverage of soft tissue defects of the distal lower extremity. The procedure is done as a single stage; the dissection is easy with short operating time and minimal morbidity.