risk factors of venous congestion after reverse sural artery flap

Background: in recent decades, the reverse sural artery flap (rsaf) has become popular for reconstructing soft tissue defects in the distal third of the tibia, ankle, or heel. previously published studies have reported limited observations of the associated complications and related factors. objectives: this cross-sectional study was conducted to determine the risk factors and their correlation with rsaf outcomes.methods: the study included patients referred to our department with soft tissue defects of the distal tibia, ankle, or heel treated using rsaf from 2019 to 2022. clinical and outpatient records were investigated to collect the data. qualitative data were reported using frequencies and percentages, and quantitative data were reported using mean±sd. results: flap congestion was reported in 71.8% of the 39 patients with variable severity. smoking, drug addiction, late referral, concomitant fractures, and soft tissue defects were associated with venous congestion at the repair site.conclusion: flap congestion is common after an rsaf. by controlling the risk factors associated with this complication, such as smoking cessation and faster referral to a surgeon skilled in reconstructing soft tissue defects, flap congestion can be reduced, thus reducing the possibility of treatment failure.