When less is more: revascularization and sural artery fasciocutaneous flaps in ischemic limb salvage

Nine patients underwent ischemic limb salvage via a combination of revascularization and wound reconstruction with a reverse sural artery fasciocutaneous flap. All flaps healed primarily. There were no untoward donor-site complications. At 6 months postoperative, limb preservation and function were maintained in this cohort. Revascularization and reverse sural artery flap reconstruction of limb-threatening ischemic wounds is a safe and reliable approach to limb salvage. Factors important in decision-making include the wound dimensions and the presence of peroneal blood flow. Serious consideration of this reconstructive plan should be given, when appropriate, over revascularization and microsurgical transplantation.