Indian Journal of Surgery

, Volume 75, Supplement 1, pp 148–149 | Cite as

Delayed Reverse Sural Flap for Cover of Heel Defect in a Patient With Associated Vascular Injury. A Case Report

  • Faizal AliEmail author
  • Hanafiah Harunarashid
  • Khandasamy Yugasmavanan
Case Report


The delay reverse sural neurofasciocutaneous flap is used to reconstruct soft tissue defects in the lower third of the leg to improve outcome in patients with associated comorbidities such as diabetes mellitus, hypertension, hypercholesterolaemia, smokers and ischaemic heart disease. The author reports the use of a delayed reverse sural flap as soft tissue cover for a calcaneal defect in a patient with associated comorbidities who has an ipsilateral Gred 3C (Gustilo) tibial fracture after vascular reconstruction.


Lower-extremity reconstruction Vascular injury Sural flap Delay procedure Limb salvage 



The author does not have any conflict of interest related to this article nor did he receive any financial support.


  1. 1.
    Erdmann D, Gottlieb N, Humphrey JS et al (2005) Sural flap delay procedure: a preliminary report. Ann Plast Surg 54:562–565PubMedCrossRefGoogle Scholar
  2. 2.
    Costa-Ferreira A, Reis J, Pinho C et al (2001) The distally based island superficial sural artery flap: clinical experience with 36 flaps. Ann Plast Surg 46:308–313PubMedCrossRefGoogle Scholar
  3. 3.
    Jeng S, Wei F (1997) Distally based sural island flap for foot and ankle reconstruction. Plast Reconstr Surg 99:744–750PubMedCrossRefGoogle Scholar
  4. 4.
    Masquelet AC, Romana MC, Wolf G (1992) Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience. Plast Reconstr Surg 89:1115–1121PubMedCrossRefGoogle Scholar
  5. 5.
    Baumeister SP, Spierer R, Erdmann D et al (2003) A realistic complication analysis of 70 sural artery flaps in a multi-morbid patient group. Plast Reconstr Surg 112:129–140PubMedCrossRefGoogle Scholar
  6. 6.
    Fisher J, Gingrass MK (1997) Basic principles of skin flaps. In: Georgiade GS, Riefkohl R, Levin LS (eds) Plastic, maxillofacial and reconstructive surgery. Williams and Wilkins, Baltimore, pp 22–24Google Scholar
  7. 7.
    Dhar SC, Taylar GI (1999) The delay phenomenon: the story unfolds. Plast Reconstr Surg 104:2079–2091PubMedCrossRefGoogle Scholar
  8. 8.
    Bishara SA, Maher MH, Ahmad MT et al (1997) Early microvascular reconstruction of Gustilo type III-C lower extremity wound: case report. Scan J Plast Reconstr Surg Hand Surg 31(4):351–355CrossRefGoogle Scholar

Copyright information

© Association of Surgeons of India 2012

Authors and Affiliations

  • Faizal Ali
    • 1
    Email author
  • Hanafiah Harunarashid
    • 2
  • Khandasamy Yugasmavanan
    • 1
  1. 1.Plastic Surgery Unit, Department of SurgeryUniversity Kebangsaan Malaysia Medical CenterKuala LumpurMalaysia
  2. 2.Vascular Surgical Unit, Department of SurgeryUniversity Kebangsaan Malaysia Medical CenterKuala LumpurMalaysia

Personalised recommendations