Extended Islanded Reverse Sural Artery flap for Staged Reconstruction of Foot Defects Proximal to Toes

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Foot defects proximal to the toes present significant reconstruction challenges.
• Traditional methods may have limitations in achieving adequate coverage and flap survival.

Purpose of the Study:

• To evaluate the efficacy of the extended delayed reverse sural artery flap for foot defect reconstruction.
• To assess flap survival rates, complication profiles, and the extent of coverage achieved.

Main Methods:

• A case series was conducted involving patients requiring foot defect reconstruction.
• The delayed reverse sural artery flap technique was employed, involving preoperative Doppler assessment and a one-week delay before inset.
• Vaccum-assisted closure (VAC) dressing was utilized postoperatively.

Main Results:

• Thirty-two patients underwent reconstruction with the delayed reverse sural artery flap.
• All flaps achieved complete survival, with minor complications including infection (9.3%), tip necrosis (9.3%), epidermolysis (6.2%), and venous congestion (6.2%).
• The flap proved effective for various etiologies, including road traffic accidents and diabetic foot wounds.

Conclusions:

• The delayed islanded reverse sural artery perforator flap is a dependable and adaptable choice for soft tissue defects.
• It offers reliable reconstruction for defects proximal to the toes with reduced complications and enhanced coverage area.