Versatility of Delayed Reverse Sural Flap for Reconstruction of the Distal Lower Extremity in High-Risk Patients

Park,  June Kyu; Kim,  Kyung Sik; Kim,  Seung Hong; Choi,  Jun; Yang,  Jeong Yeol

doi:2017.22.4.280

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Original Article

Archives of Hand and Microsurgery 2017;22(4):280-287.
Published online December 1, 2017.
DOI: https://doi.org/10.12790/ahm.2017.22.4.280

Versatility of Delayed Reverse Sural Flap for Reconstruction of the Distal Lower Extremity in High-Risk Patients

June Kyu Park, Kyung Sik Kim, Seung Hong Kim, Jun Choi, Jeong Yeol Yang

Department of Plastic Surgery, Myongji Hospital, Goyang, Korea. kskimps@mjh.or.kr

Received: 9 June 2017 • Revised: 17 August 2017 • Accepted: 1 September 2017

Abstract

Purpose
Soft tissue defects in the distal lower extremity represent a special challenge for reconstructive surgeons. Various methods of lower-limb wound coverage have been described, such as local flaps, distant flaps, and free flaps. Among various methods, the delayed reverse sural flap can be one of the several options for the reconstruction of distal lower extremity in high-risk patients. We report our experiences with the versatile, delayed reverse sural flap for coverage of the distal lower extremity in high-risk patients.

Methods
From September 2015 to October 2016, seven patients with soft tissue defects of the distal lower extremity were treated with the delayed reverse sural flap based on a two-step procedure. All patients had significant medical comorbidities, such as diabetes mellitus, peripheral arterial disease, and smoking. The delay period ranged from 10 to 14 days, and the flap size was from 7.5×2.0 to 14.5×4.0 cm.

Results
Six flaps survived without complications. One flap showed partial necrosis due to venous congestion but eventually survived.

Conclusion
Because the delay procedure improves flap viability, the delayed reverse sural flap may be a reliable and efficient alternative for reconstructing soft tissue defects of the distal lower extremity in high-risk patients.

Key Words: Sural, Lower extremity, Risk

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