Complex Technique of Large Sural Flap: An Alternative Option for Free Flap in Large Defect of the Traumatized Foot

  • Naser Mohammadkhah Plastic Surgeon, Department of Plastic and Reconstructive, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Sadrollah Motamed Plastic Surgeon, Department of Plastic and Reconstructive, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Seyed Nejat Hosseini Mail Department of Plastic Surgery, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. AND Plastic Surgeon, Department of Plastic and Reconstructive, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Hamid Reza Hallajmofrad Plastic Surgeon, Department of Plastic and Reconstructive, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Madjid Abdolzadeh Plastic Surgeon, Department of Plastic and Reconstructive, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Lotfallah Afzali Borujeni Plastic Surgeon, Department of Plastic and Reconstructive, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Seyednouraddin Mousavinasab Department of Plastic Surgery, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Keywords:
Surgical flaps, Sural, Reconstructive surgical procedure, Foot, Heel

Abstract

The distally based sural fasciocutaneous flap has become a main part of the reconstruction of the lower leg, heel and foot. However, perfusion problems and venous congestion have been reported. Over the past decade, several flap modifications have been reported to improve flap viability and to solve a myriad of reconstructive needs. The purpose of this paper is to describe our experience in harvesting the reversed large sural flap from the proximal and middle third of the leg for large defects on the foot. We applied the extended reversed sural flap from the proximal third of the leg in traumatized patients which had large defects on their foot. The technique was done in 3 parts: 1- the flaps were designed in the proximal third of the leg five centimeter lipofascial tissue was protected around the pedicle in distal part; 3- The pivot point was located in seven to eight cm proximal the lateral malleolus before the first fasciocutaneous perforators arising from the peroneal artery. Sural flaps from the proximal and middle third of the leg were designed in13 patients who had large defects on their foot. No flap necrosis or split thickness skin graft loss occurred. The flaps healed by the 3rd week excluding two patients. This study supports the application of our technique as a safe, easy and useable method in large defects of the foot. The results showed low rates of ischemia, venous congestion, dehiscence, infection and flap necrosis. Proximal extended and large distally based sural flap is an alternative to free tissue transfer for large defect reconstruction of the foot.

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How to Cite
1.
Mohammadkhah N, Motamed S, Hosseini SN, Hallajmofrad HR, Abdolzadeh M, Afzali Borujeni L, Mousavinasab S. Complex Technique of Large Sural Flap: An Alternative Option for Free Flap in Large Defect of the Traumatized Foot. Acta Med Iran. 49(4):195-200.
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