Distally based perforator sural flaps for foot and ankle reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Distally based perforator sural flaps are neurofasciocutaneous flaps originating from the lower leg.
• These flaps are supplied by perforating arteries from the deep peroneal or posterior tibial arteries, linked by an adipofascial neurovascular axis.
• They offer a valuable alternative for soft-tissue reconstruction in the foot and ankle region.

Purpose of the Study:

• To detail the history, vascular supply, and surgical techniques of distally based perforator sural flaps.
• To explore flap variations, indications, and demonstrate efficacy through case reports.
• To highlight the versatility and reliability of this reconstructive method.

Main Methods:

• Review of developing history and vascular anatomy.
• Description of surgical techniques, including flap design, elevation, and variations.
• Presentation of illustrative case reports with different perforating vessels as pivot points.

Main Results:

• Demonstrated versatility and reliability of distally based perforator sural flaps for foot and ankle reconstruction.
• Successful soft-tissue coverage achieved using flaps based on various perforating vessels.
• Preservation of major arteries, avoiding sacrifice for flap transfer.

Conclusions:

• Distally based perforator sural flaps are a versatile and reliable option for foot and ankle soft-tissue reconstruction.
• The technique allows for 180-degree rotation and avoids sacrifice of major arteries.
• This method provides effective coverage with diverse vascular pedicle options.