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[The de-epidermized sural flap: An original technique to increase the reliability of the neurocutaneous sural flap]
F Thuau1, U Lancien1, V Crenn2
1Service de chirurgie plastique et reconstructrice, centre de traitement des brûlés adultes et enfants, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
Background:
The neurocutaneous sural flap is useful to cover defects of the distal quarter of the lower limb. Nevertheless, severe complications occur in 14% of the cases, and venous congestion is reported in 75% of these cases. This congestion can lead to total necrosis of the flap and a failure of the procedure. We describe a new surgical method aiming to reduce the risk of venous congestion occurrence and failure of the defect coverage.
Patients And Methods:
We realized a retrospective study of patients who undergone a de-epidermized distally based neurocutaneous sural flap in our surgery department from 2015 to 2020. The following data were collected: sex, age, vascular risk factors, size of the wound, defect area, etiology, delay between the surgery of the flap and the split-thickness skin graft and complications.
Results:
The cohort is composed of 5 cases. We reported no failure of the coverage of the defect. There were no cases of venous congestion.
Conclusion:
The de-epidermized distally based neurocutaneous sural flap could increase the reliability of these flaps by reducing the risk of venous congestion. A larger study comparing the classic technique to the de-epidermized sural flap could confirm these data on a greater number of cases and position this technique in the therapeutic arsenal.
