From the Guidelines
The reverse sural (superficial sural) artery flap is a fasciocutaneous flap utilized for soft tissue coverage of defects in the lower extremity, particularly in the distal third of the leg and foot [no relevant evidence provided, however, based on general medical knowledge].
Key Characteristics
- The procedure involves harvesting a skin flap from the posterior aspect of the leg, based on the sural artery and vein, and reversing its direction to cover the defect.
- The flap is typically used to cover defects in the lower extremity, such as those resulting from trauma, infection, or tumor resection.
- Post-operative management is crucial to minimize the risk of complications, such as wound breakdown and infection 1, although this study does not directly discuss the reverse sural artery flap, it highlights the importance of proper wound management.
Important Considerations
- Sural nerve injuries are a potential complication of the procedure, although the provided evidence does not discuss this in the context of the reverse sural artery flap 1.
- The use of prophylactic antibiotics may be considered to minimize the risk of infection, however, the provided evidence does not discuss the specific use of antibiotics in the context of the reverse sural artery flap.
- Based on general medical knowledge, elevation of the affected limb and bed rest are typically recommended post-operatively to promote healing and minimize the risk of complications.
From the Research
Definition and Purpose of the Reverse Sural Artery Flap
- The reverse sural (superficial sural) artery flap is a fasciocutaneous flap used for soft tissue coverage of defects in the lower limb, particularly in the distal third of the leg, ankle, heel, and foot 2, 3, 4, 5, 6.
- The flap is based on the superficial sural artery and can be used to cover a variety of defects, including those caused by trauma, diabetic ulcers, and other conditions 2, 3, 4, 5, 6.
Characteristics and Advantages of the Flap
- The reverse sural artery flap is a versatile and reliable procedure that can be used to cover large and complex defects in the lower limb 3, 4, 6.
- The flap has a long pedicle, which allows for distalization up to the dorsum of the midfoot 4.
- The flap is easy and quick to elevate, and can be used as an alternative to microsurgical procedures in cases where such facilities are not available 4.
- The flap has a low risk of complications, including arterial crisis and venous congestion 6.
Clinical Applications and Outcomes
- The reverse sural artery flap has been used successfully to cover soft tissue defects in a variety of clinical settings, including traumatic injuries, diabetic ulcers, and other conditions 2, 3, 4, 5, 6.
- The flap has been shown to have a high success rate, with most patients experiencing uneventful healing and minimal complications 2, 3, 4, 5, 6.
- The flap can be used in patients with risk factors such as diabetes, advanced age, and cigarette smoking, although these factors may increase the risk of complications 6.