S-shaped reverse sural flap for reconstruction of tissue defect on heel

Hamid Reza Fathi, Mehdi Fathi, Mihan J Javid, Hamid Reza Fathi, Mehdi Fathi, Mihan J Javid

Abstract

Traumatic limb injury is a prevalent lesion in Iran. Motorcycle accidents are responsible for most of these traumatic lesions. Despite various reported techniques, the coverage of the Achilles tendon, malleoli, ankle and heel is still daunting and demanding procedure. S-shaped reverse sural flap is a modified technique of reconstruction. In this report of 6 patients underwent surgical reconstruction by this modified technique we discuss about the technique as a simple and safe technique with low morbidity rate and recommend using this technique in complex injuries.

Keywords: Limb trauma; modified technique; reverse sural flap.

Figures

Figure 1:
Figure 1:
Diagram of the S-shaped reverse sural flap showing relevant applied surgical anatomy.
Figure 2:
Figure 2:
Clinical photographs in case 1. S-shaped reverse sural flap for reconstruction of tissue defect on heel. (a) Wound of the recipient region. (b) Fasciocutaneous island of sural flap was elevated. (c) Postoperative appearance with S-like scar of the donor site.

References

    1. Hallock GG. Distally based flaps for skin coverage of the foot and ankle. Foot Ankle Int. 1996;17:343–8. doi: 10.1177/107110079601700609.
    1. Gu YD, Wu MM, Li HR. Lateral lower leg skin flap. Ann Plast Surg. 1985;15:319–24. doi: 10.1097/00000637-198510000-00008.
    1. Satoh K, Aoyama R, Onizuka T. Comparative study of reverse flow island flaps in the lower extremities: Peroneal, anterior tibial and posterior tibial island flaps in 25 patients. Ann Plast Surg. 1993;30:48–56. doi: 10.1097/00000637-199301000-00007.
    1. Donski PK, Fogdestam I. Distally based fasciocutaneous flap from the sural region. Scand J Plast Reconstr Surg. 1983;17:191–6. doi: 10.3109/02844318309013118.
    1. Amarante J, Costa H, Reis J, Soares R. A new distally based fasciocutaneous flap of the leg. Br J Plast Surg. 1986;39:338–40. doi: 10.1016/0007-1226(86)90043-3.
    1. Masquelet AC, Beveridge J, Romana C, Gerber C. The lateral supramelleolar flap. Plast Reconstr Surg. 1988;81:74–81. doi: 10.1097/00006534-198801000-00014.
    1. Chang SM. The pedicle of neurocutaneous island flaps. Plast Reconstr Surg. 1996;98:374–6. doi: 10.1097/00006534-199608000-00036.
    1. Ballmer FT, Hertel R, Noetzli HP, Masquelet AC. The medial malleolar network: A constant vascular base of the distally based saphenous neurocutaneous flap. Surg Radiol Anat. 1999;21:297–303. doi: 10.1007/BF01631327.
    1. Almeida MF, de Costa PR, Okawa RY. Reverse-flow island sural flap. Plast Reconstr Surg. 2002;109:583–91. doi: 10.1097/00006534-200202000-00027.
    1. Baumeister SP, Spierer R, Erdmann D, Sweis R, Levin LS, Germann GK. A realistic complication analysis of 70 sural artery flaps in a multimorbid patient group. Plast Reconstr Surg. 2003;112:129–40. doi: 10.1097/01.PRS.0000066167.68966.66.
    1. Ayyappan T, Chadha A. Super sural neurofasciocutaneous flaps in acute traumatic heel reconstructions. Plast Reconstr Surg. 2002;109:2307–13. doi: 10.1097/00006534-200206000-00022.
    1. Carriquiry CE, Costa MA, Vasconez LO. The anatomic study of the septocutaneous vessels of the leg. Plast Reconstr Surg. 1985;76:354–61. doi: 10.1097/00006534-198509000-00003.
    1. Le Huec JC, Midy D, Chauveaux D, Calteux N, Colombet P, Bovet JL. Anatomic basis of the sural fasciocutaneous flap: Surgical applications. Surg Radiol Anat. 1988;10:5–13. doi: 10.1007/BF02094065.
    1. Masquelet A. The posterolateral malleolar flap of the ankle: A distally based sural neurocutaneous flap-Report of 14 cases. Plast Reconstr Surg. 1995;96:406–7. doi: 10.1097/00006534-199508000-00022.
    1. Ponten B. The fasciocutaneous flap. Its use in soft tissue defects of the lower leg. Br J Plast Surg. 1981;34:215–20. doi: 10.1016/S0007-1226(81)80097-5.
    1. Numanoglu A, Esemenli T, Uzunismail A, Bas L. The ‘lazy- V de-epithelialized turnover fasciocutaneous flap in the reconstruction of skin defects after tendo Achilles repair. Br J Plast Surg. 1992;45:550–3. doi: 10.1016/0007-1226(92)90154-P.
    1. Hyakusoku H, Tonegawa H, Fumiiri M. Heel coverage with a T-shaped distally based sural island fasciocutaneous flap. Plast Reconstr Surg. 1994;93:872–6. doi: 10.1097/00006534-199404000-00036.
    1. Chang SM, Zhang F, Yu GR, Hou CL, Gu YD. Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle. Microsurgery. 2004;24:430–6. doi: 10.1002/micr.20069.
    1. Zhang F, Chang SM, Lin SQ, Song YP, Zheng HP, Lineaweaver WC, et al. Modified distally based sural neuro-veno-fasciocutaneous flap: Anatomical study and clinical applications. Microsurgery. 2005;25:543–50. doi: 10.1002/micr.20162.

Source: PubMed

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