The modified reverse sural artery flap lower extremity reconstruction

The Journal of Trauma
Mark P ForanRonald P Silverman

Abstract

The reverse sural artery flap eliminates the need for long and technically demanding free tissue transfers, which have become the gold standard for significant tissue defects in the distal third of the leg and ankle. Unfortunately, the originally described reverse sural artery flap technique has a risk of partial or total flap necrosis as high as 25%. We hypothesized that delaying the flap (the delay time ranged from 48 hours to 2 weeks) and using a 4-cm wide pedicle would decrease the amount of partial flap necrosis that commonly occurs with this flap. Five patients (3 women, 2 men) with open wounds in the distal lower extremity were treated with delayed fasciocutaneous reverse sural artery flaps elevated on a 4-cm wide pedicle. The patients ranged from 22 to 75 years of age and had sustained defects in the ankle region resulting from trauma. All five wounds healed with favorable functional and asthetic results without any evidence of flap necrosis. In patients with known vasculopathy, a surgical delay of 1 week and increasing the pedicle size to 4 cm may increase the likelihood of graft survival and decrease the amount of partial flap necrosis by dilating the arterial network.

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Citations

Mar 27, 2010·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Goran StevanovićIgor Smiljković
Sep 3, 2011·Journal of Emergencies, Trauma, and Shock·P R BoopalanThilak S Jepegnanam
Mar 26, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Catherine de BlacamBernard T Lee
Jul 20, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·John Heineman, Wei F Chen
Mar 5, 2017·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Wael Hussein Mahmoud
Mar 29, 2019·Plastic and Reconstructive Surgery·Christopher S CroweKari A Keys
Apr 12, 2012·The Journal of Trauma and Acute Care Surgery·Jian-Wei WeiAi-Yong He
Oct 27, 2015·Plastic and Reconstructive Surgery. Global Open·Kristoffer B SuggDavid L Brown

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