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Published on: October 14, 2013
A modified technique for transposition of the reverse sural artery flap
Levent Buluç1, Bilgehan Tosun, Cenk Sen
1Department of Orthopedics and Traumatology, Kocaeli University School of Medicine, Derince, 41900 Kocaeli, Turkey. leventbuluc2001@yahoo.com
Background:
Coverage of a soft-tissue defect of the lower third of the leg is a difficult problem. The reverse sural artery flap, first described by Masquelet, is a random type of flap, based on the superficial sural artery.
Methods:
We treated 10 patients with 11 reverse sural artery flaps. A modification of flap transposition through a subcutaneous tunnel with the aid of a soft-tissue expander was described to prevent venous congestion, especially in longer tunnels, for flap insetting.
Results:
Eight flaps survived completely. Distal tip and partial skin necrosis was observed in three flaps in two diabetic patients (27.2 percent). No venous congestion was observed after this modification.
Conclusion:
The reverse sural artery flap is a reliable alternative for small to moderate size defects and can be used with modifications of the original technique.
