Sobia Manzoor,1 Nauman Ahmed Gill,2 Ehsan Ahmed Khan3
03/08/2021 | Published:
04/09/2021 | Pages:
Standard reverse sural artery flap is a valuable option for reconstruction of soft tissue defects of lower third of leg, hind foot and dorsum of foot, but it is prone to develop venous congestion. We have introduced a novel technique of extended pedicle reverse sural artery flap which has shown better flap survival and outcome.
Methodology: This was a retrospective review of data of patients who underwent standard or extended pedicle reverse sural artery flap for post traumatic wounds of lower leg, ankle, heel and mid foot dorsum, over a period of 6 years (September 2015 to September 2021). Data was retrieved from hospital admission and operation records and case files of the patients for analysis. Outcome variables like flap survival and pattern of necrosis were recorded. Results: Of the 56 patients who underwent reverse sural artery flap coverage for distal lower extremity, Standard reverse sural artery flap was done in 30(53.6%) and Extended pedicle flap done in 26(46.4%) patients. The mean± SD age of the patients was 15.96±11.3 years. Males accounted for 66.1% (n=37) of patients. Non weight bearing heel was the most common site (n=25, 44.7%), whereas wheel spoke injury was the most common cause(n=33, 58.9%). Mean size of wound was 8.2×6.5 cm for which dimensions of flap elevated were 9×7 cm. Rate of complications was significantly less in extended pedicle reverse sural artery flap (p value 0.037). Flap survival was 25(96.2%) in Extended pedicle reverse sural artery flap group (p value 0.008) with Excellent outcome (p value 0.006). Conclusion: Extended pedicle reverse sural artery flap is reliable option for coverage of defects around ankle and heel with better flap survival and excellent outcome.