Neuro Sural Flap Review of the Literature

Abstract

Reconstruction of loss of substance of the lower third of the leg, the heel and the forefoot is a real problem. New knowledge of the cutaneous vascularization, emanating from the neurovascular axes, has led to the discovery of new cutaneous flaps, including the sural neurocutaneous flap. It is a good alternative for the coverage of moderate losses of substance of the heel and the lower third of the leg. The aim of this retrospective study is to report our experience and to evaluate the reliability of the weaned sural neurocutaneous flap in the coverage of the lower third of the leg. This study took place in the Department of Plastic, Reconstructive and Burn Surgery of Al Kortobi Hospital in Tangier, Morocco. This is a retrospective study including six patients with skin loss of the lower third of the leg and in whom coverage was performed by sural neuro cutaneous flap, the study period was between March 2021 and June 2022. Six patients were included in this study, there were 3 males and 3 females, their age ranged from 19 to 60 years with an average age of 40 years. In the series studied, the origin of the loss of substance was predominantly tumoral (2 cases of squamous cell carcinoma and 1 case of synovial sarcoma) and post-traumatic (2 cases). The location of the loss of substance is predominantly on the right side compared to the left side. Their location is distributed as follows: the heel (1 case), the lower 1/3 of the leg (2 cases), the dorsal aspect of the foot (1 case), the lateral malleolus (1 case) and the medial malleolus (1 case). There are many techniques for the management of loss of substance of the lower limb: directed healing, pedicled flap, or even free flap. Reconstruction of loss of substance of the lower limb by pedicled flaps is now a good therapeutic choice. The sural neurocutaneous flap is recognized as a flap whose dissection is technically uncomplicated and which makes it possible to cover significant loss of substance in the lower limb.