Distally Based Superficial Sural Artery Flap for Reconstruction of Soft-Tissue Defect of the Lower Leg- A Report of Two Cases

Abstract

Satisfactory reconstruction of soft-tissue loss over the lower leg still remains a great challenge for plastic surgeons. Many different designs including axial flaps, fascial flaps, muscle flaps, septocutaneous flap, and free flaps have been tried to solve this problem. Two cases of soft-tissue loss, over the anteromedial aspect and heel region of the lower leg respectively, were selected for reconstruction with distally based superficial sural artery flaps. Both flaps survived well without major sequlae. However, hyperesthesia or numbness over the lateral aspect of the lower leg is the main shortcoming. This flap is a fasciocutaneous island flap supplied by the superficial sural artery. It has the following advantages: 1. its blood supply is rather reliable; 2. the pedicle is long enough to cover the defect between the mid-calf and mid-foot; 3. no major arteries need to be sacrificed; 4. the donor site defect can be directly closed or grafted with minimal morbidity; 5. flap elevation is easy and time-saving; 6. it is a one stage operation, in selected cases.