Success of reverse suralfasciocutaneous flap for coverage of soft tissue defect of distal limb: Our experience

Background: provision of coverage for soft-tissue defects of the distal leg is a challenge,particularly in patients with multiple trauma and peripheral vascular disease. the fasciocutaneous flap has constant septocutaneous perforators,ensuring perfusion of the flap. aim: to review the success of reverse sural artery flap for dislattibial,ankle and heel defects in our setup. methods:total 21 patients of soft tissue defect involving lower third of legwere included. patients with peripheral vascular disease,neuropathic ulcers and trophic ulcers were excluded.reverse suralfasciocutaneous flap was designed on posterior aspect of affected leg based upon septocutaneous perforator vessels,placed over defect anchored with vicryl 4/0 and half buried mattress suture. patients were discharge on 3rd post op day in case of uneventful recovery and followed up on 5th,15th day and then monthly till 4th month and outcome was measured in terms of flap survival and any major complications. results:mean age was 33.33±18.78 years. male were 76% and female were 24% with male to female ratio of 3.2:1. road traffic accident was the main cause (62%) of defect with heal was involved in 44% cases. success (absence of necrosis and 100% coverage of the defect) of perforator based sural flap for coverage of distal limb was seen in 38% patients. out of the 13 patients with complications,partial flap necrosis was seen in 6% patients,wound dehiscence in 25% and superficial wound infection in 33.33% patients. conclusion:this study concluded that success of the perforator based sural flap for coverage of soft tissue defect of distal limb is higher.