Mini-delayed reverse flow sural artery flap: Maximising the reach and minimising the hospital stay

Published Date: 14th August 2018

Publication Authors: Alfeky H

​Aim

Microsurgical free tissue transfer is the gold standard for reconstruction of the lower leg defects. However it can be technically difficult or unavailable, hence local tissues can provide the solution. The distally based sural artery flap with or without delaying is one of the available options.

Methods

14 patients with lower leg and foot defects where managed in a 2 stage procedure using the delayed reverse flow sural artery flap. The delay period ranged from 7 to 10 days (mean 8.1), the length of the flap ranged between 12 and 20 cm (mean 16.5), and the width between 7 and 10 cm (mean 8.6).

Results

All patients were discharged between the 2 procedures. Total period of admission ranged from 1 to 3 days (mean 1.7). All flaps survived and healed well without any complications apart from two patients had partial superficial flap necrosis.

Conclusion

Flap delay enhances the viability of large reverse sural flaps with minimal complication rates. We recommend this technique for patients with large defects at the dital third of the lower leg or foot or concomitant diseases such as diabetes or peripheral vascular disease. We also propose a new algorithm for the delay procedure in lower leg limbs.

 

Alfeky, H; Taha, A; Helmy. (2018). Mini-delayed reverse flow sural artery flap: Maximising the reach and minimising the hospital stay. International Journal of Surgery. 55 (Suppl 1), S95

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