Related Experiment Video
Updated: Mar 28, 2026
09:04
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
9.4K
Distal lower extremity coverage by distally based sural flaps: Methods to increase their vascular reliability
C Herlin1, R Sinna2, M Hamoui3
1Service de chirurgie plastique et reconstructrice, centre des brûlés, CHRU Lapeyronie, 325, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France; Service de chirurgie plastique et craniofaciale pédiatrique, CHRU Lapeyronie, 34295 Montpellier cedex 5, France.
Annales De Chirurgie Plastique Et Esthetique
|December 25, 2015
Summary
Distally based sural flaps offer a safe reconstructive option when microsurgery isn't feasible. Careful pedicle dissection and managing venous drainage, including short saphenous vein anastomosis or ligation, enhance flap reliability.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Vascular Anatomy
Background:
- Distally based sural flaps are established reconstructive techniques.
- Harvesting methods vary, often lacking detailed vascular anatomical data.
- Optimization is needed for safe and customized flap use.
Purpose of the Study:
- To review existing harvesting techniques for distally based sural flaps.
- To synthesize clinical experience with flap harvesting.
- To provide guidelines for optimal, safe, and customized flap utilization.
Main Methods:
- Review of 58 distally based sural flaps in 53.4-year-old patients.
- Analysis of flap characteristics: fasciocutaneous, tunneling, skin blade preservation.
- Evaluation of short saphenous vein management: anastomosis and distal ligation.
Main Results:
- Venous congestion occurred in 31% of flaps, managed by anastomosis or distal ligation.
- Partial skin paddle necrosis occurred in 10.3% of flaps, with 8.6% successfully reconstructed.
- One patient required secondary flap coverage.
Conclusions:
- Distally based sural flaps are a safe reconstructive choice when microsurgery is not possible.
- Pedicle dissection and venous drainage management should be individualized.
- Anastomosis or ligation of the short saphenous vein and preserving a skin blade improve flap vascular reliability.
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