Outcome of Delayed Distally Based Sural Flap for Distal Tibial and Foot Defects

Abstract

Abstract: Background: Lower limb defects can be tricky to repair. We have limited options for reconstruction in the leg and foot region. Sural flap is considered as the workhorse for reconstruction of these defects. We present our case series of delayed reverse sural flap. Objective: To determine the outcome of Delayed Distally based sural flaps for distal tibial and foot defects. Materials and Methods: Study was carried out at plastic and reconstructive unit HMC and MMC. Over a period of 10 years from January, 2009 to December, 2018. This is a cross sectional study, presenting with soft tissue defects of foot. Patients presented in the emergency, as an outpatient or as referrals from another center. All patients were admitted and operated as elective cases. Result: In 24 patients, there were no complications. Two patients (6%) had partial flap loss and required revision surgeries. Two patients had marginal flap necrosis and were treated conservatively. Conclusion: This study presents our experience with use of reverse sural flap. It provides a reliable option for foot and distal leg defects. It is relatively easy to do and easy to learn. It can be attempted in centers where expertise or facilities for microvascular surgery are not available and in patients who are not ideal candidates for a free flap. Keywords: Sural flap, Foot and leg defects, Delayed reverse sural flap, Peroneal perforators, Fasciocutaneous flap, Sural angiosome.