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KMID : 1143020170220040280
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Archives of Hand and Microsurgery
2017 Volume.22 No. 4 p.280 ~ p.287
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Versatility of Delayed Reverse Sural Flap for Reconstruction of the Distal Lower Extremity in High-Risk Patients
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Park June-Kyu
Kim Kyung-Sik
Kim Seung-Hong
Choi Jun
Yang Jeong-Yeol
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Abstract
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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.
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KEYWORD
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Sural, Lower extremity, Risk
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