COMPARISON OF THE USE OF THE SURAL FLAP FOR THE MEDIAL, LATERAL, AND CENTRAL REGIONS OF THE ANKLE

To evaluate the occurrence of partial or total loss of the reverse-flow sural flap used for coverage failures in the lateral, medial, and central regions of the ankle, as well as factors related to flap loss.

A retrospective cohort study was conducted including data from 32 patients who underwent surgery with reverse sural flaps between February 2012 and September 2023 at the Institute of Orthopedics and Traumatology, HC/FMUSP.

In the group of patients requiring coverage in the medial region, 40% had partial flap loss and 30% suffered total loss. In the lateral region, 20% experienced partial loss and 13.3% total loss. In the central area, 57.14% had partial coverage loss, with no cases of total loss.

The reverse sural flap proved to be favorable for coverage of defects in the lateral region of the ankle, but showed higher rates of partial or total loss when used for coverage of defects in the medial region of the ankle. A negative effect was observed in the presence of patient comorbidities, in trauma-related cases, and in the early approach to flap construction. Level of Evidence II; Retrospective cohort study.