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The distally based sural artery flap

R L Huisinga1, P Houpt, R Dijkstra

  • 1Department of Plastic, Reconstructive and Hand Surgery, Sophia Hospital, Zwolle, The Netherlands.

Annals of Plastic Surgery
|July 25, 1998
PubMed
Summary

The sural artery flap offers a versatile solution for lower leg, ankle, and heel defects, even in compromised patients. This flap provides a large rotation arc without sacrificing major arteries, demonstrating high success rates.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Microsurgery

Background:

  • The sural artery flap is a distally based fasciocutaneous flap utilized for lower extremity reconstruction.
  • It relies on reverse flow from peroneal artery anastomoses to the medial sural nerve vascular network.
  • Reconstruction of lower leg, ankle, and heel defects presents unique challenges, particularly in patients with compromised vasculature.

Observation:

  • This study evaluated the utility of the sural artery flap in 15 patients with defects in the lower leg, malleolar, and heel regions.
  • Seven of these patients had significant vascular compromise.
  • The flap's large arc of rotation and ability to preserve major arteries were noted as key advantages.

Findings:

  • The sural artery flap demonstrated a high success rate, with 12 out of 15 flaps surviving completely.

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  • Two flaps experienced partial survival, and one flap failed.
  • The procedure was noted for its simplicity of dissection and low donor site morbidity.

    • Implications:

    • The sural artery flap is a reliable and effective option for reconstructing challenging defects in the lower leg, ankle, and heel.
    • Its use is particularly beneficial in vascularly compromised patients, offering a viable alternative to other reconstructive methods.
    • The flap's advantages include a significant arc of rotation, preservation of major arterial supply, and minimal donor site morbidity, making it a valuable tool in reconstructive surgery.