Fasciocutaneous sural flap for softtissue coverage in the third distal leg, ankle and foot.

Background The objective of this paper is to evaluate the results after the use of distally-based reverse fasciocutaneous sural flap in the reconstruction of soft-tissue loss around the distal tibia, ankle and foot. Methods 37 fasciocutaneous pedicled reverse sural flaps performed between 2008 and 2016 were retrospectively evaluated. Average age of the patients: 49 years (range 8-90). Soft-tissue loss was post-traumatic in 27 cases, 7 cases presented soft tissue defect after pressure sores (two bilateral) and three patients presented skin necrosis secondary to surgical procedure. Defect size averaged 9,6 x 6,7 (15 x 9) cm. Results Follow-up averaged 18 months. Complete softtissue defect coverage was achieved in 29 cases. Three flaps had partial necrosis and five suffered completed necrosis, four of them had history of vascular disease. Conclusions Although multiple coverage options have been described for soft-tissue coverage around the distal tibia, ankle and foot, the reverse sural flap is one of the most frequently used procedures to cover these defects. We evaluated 37 reverse sural flaps, achieving good results with low percentage of complications and morbidity