Reconstruction of Defects of the Lower Third of the Leg and Foot With a Reverse Sural Island Flap
Author(s): Sokol Isaraj, Nardi Kola, Ina Kola
Background: Closure of lower limb defects asks for thorough knowledge of all the reconstructive options, starting with the use of local tissues. The scarce availability of such, makes this task difficult and demanding. Unique nature of blood supply to the leg, complicates this issue even more. Reverse sural island flap is what we found handy in solving the problem for defects of small to moderate size, on the lower leg and foot.
Objectives: The aim of this study is to report our experience with the use of the reverse sural island flap in the reconstruction of complex soft tissue defects of the lower leg and the foot.
Materials and methods: Following institutional review board approval, a database search was completed to identify all patients who underwent reconstruction of distal lower extremity and foot defects with a reverse sural island flap between 2011-2019. Data were collected from the medical records of patients, as regards: demographics, history of trauma or nature of the wound, personal medical history (accompanying diseases, smoking status), location of the defect, dimensions of the flap after being elevated, pedicle length etc.
Results: 15 cases received a reverse sural island flap, all the cases except one, being acute trauma. The remaining one was a chronic wound after a previous burn. In one of the cases the flap was delayed. In three of them flap it was used to cover defects of the dorsum of the foot. Flap dimension varied from 7 × 4 cm to 15 × 12 cm, length of the pedicle from 6 to 16 cm, two of the flaps were very close to the distal popliteal crease. In all of the cases, except one, donor area of the flap needed be skin grafted. Only two of the flaps were complicated: one by a partial necrosis, the other by a venous stasis, which in the end were both treated successfully. In none of the patients a