Reconstruction of the lower leg with the sural artery flap

Abstract

Background. Soft tissue covering on the lower leg is frequently a difficult challenge and causes increasing problems for treatment in smaller hospitals. We introduce a plastic surgery method for covering these soft tissue defects.

Method. An island of skin, centered above the sural nerve, is cut out in the middle dorsal area of the lower leg. The subcutaneous vascular pedicle is prepared along the nerve. The gained skin flap is rotated into the defect site and fixed without tension. The wound of the donor-site defect is usually closed primarily, and the flap pedicle is covered with Meshcraft.

Results. In 18 of the 21 patients treated by this method the flap healed without functional impairment, one patient experienced a necrosis leading to the loss of the flap. And a partial loss of the skin island was recorded in two cases, complete healing was achieved by means of Meshcraft transplantation.

Conclusions. The superficial sural artery flap usually results in a reliable and complete healing of soft tissue defects within the area of the lower legs with justifiable operational expenditures also for elderly patients and those with vascular ailments.