Reversed superficial sural artery adipofasciocutaneous flap: is it a versatile flap?

One of the major problems faced by the reconstructive surgeon is how to cover soft tissue defects having exposed bones and tendons in the lower third of the leg, ankle, heel, and foot. The distally based superficial sural artery flap is an effective alternative for such reconstructions. The distally based superficial sural artery adipofasciocutaneous flap is supplied by the perforators of peroneal artery as a reverse flow flap. From 1999 to 2004, we used a distally based superficial sural artery flap for the reconstruction of the ankle heel and foot in 11 patients. The largest flap used was 15 cm in width and 18 cm in length. Nine flaps survived completely and two necrosed partially. Mild edema and congestion were observed in most of the flaps, but these observed conditions improved with time. The main advantages included reliable blood supply without sacrificing any major artery of the limb and easy, simple, and quick elevation.