REVERSE SURAL FLAP FOR LOWER LIMB RECONSTRUCTION

Area of Science:

• Plastic Surgery
• Orthopedic Surgery
• Wound Reconstruction

Background:

• Reconstructing distal lower extremity wounds is challenging due to limited local tissue availability.
• Fasciocutaneous and muscular flaps, like the reverse-flow fasciocutaneous sural flap, are viable coverage options.

Purpose of the Study:

• To evaluate the 18-month experience of the Complex Wounds Group at the University of São Paulo Medical School in reconstructing ankle, calcaneus, and foot injuries using the reverse-flow sural flap.

Main Methods:

• An observational, retrospective, and descriptive study was conducted.
• Data was collected from medical records of patients treated between November 2018 and June 2020.

Main Results:

• Nine reverse-flow fasciocutaneous sural flaps were performed on male patients with a mean age of 38.
• The most common injuries were acute wounds from traffic collisions, electrical trauma, and chronic post-traumatic injuries affecting the ankle, foot, and calcaneus.
• Four patients experienced complications: three with partial necrosis and one with distal epitheliosis. No total necrosis occurred. Average hospital stay was 30.1 days.

Conclusions:

• The reverse-flow fasciocutaneous sural flap is a viable, reproducible, and reliable technique for distal lower limb reconstruction.
• This flap offers a promising solution for complex lower extremity wounds, demonstrating a favorable safety profile.