Background and objective

Reconstruction of the middle and distal third of the leg, heel injuries and even the middle third of the foot, suppose a constant challenge for the reconstructive surgeon. However, the reverse flow sural flap represents an important and widely used tool for these defects. This flap is based on the reverse flow of the middle superficial sural artery, which depends on the perforator of the peroneal artery. It has advantage because is easy to perform and as disadvantage, venous congestion, so this was our motivation to conduct this study.

Methods

A total of 14 reverse flow sural flaps were performed in the Department of Plastic Surgery of the Dr. Rubén Leñero General Hospital (Mexico), with a pedicle that measured 100% of the cutaneous island to cover defects of the distal 1/3 of the lower limb and the proximal 2/3 of the foot.

Results

All flaps survived, without the presence of venous congestion, using a safe and easily performed technique that guarantees the viability of the flap.

Conclusions

The reverse flow sural flap with all-amplitude pedicle of the width of the skin island, it is a safe and easy-to-realize flap for coverage of bloody areas in the distal 1/3 of the leg, 1/3 middle and proximal and even distal of the foot, since this new technique we present eliminates the main complication of conventional sural flap and of other modifications, which is venous congestion that evolves to partial or total necrosis of the flap. We recommend to perform it with total amplitude request of the skin island, since this manages to preserve more capillary connections (venulas-arteriolas), allowing the arterial flow to have a balances pathway of drainage and therefore, guarantee the success.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )