DISTALLY BASED SURAL ISLAND FLAP FOR THE LOWER LEG, ANKLE AND FOOT RECONSTRUCTION

摘要

Through study and use of 150 distally based sural island flaps for the calcaneal area, malleoli, lower part of the limb, foot and ankle reconstruction, we initially find out some conclusion points as follows: 1. Use of the distally based sural island flaps has the following advantage: 1.1 A one-stage operation is required, without the need for microsurgical techniques. 1.2 Elevation of the flap is easy and quick. The vascular supply is constant and reliable, and there is no need to sacrifice any major artery or sensory nerve. 1.3 The pedicle is long, and the island flap can be transferred as far to the instep area. 1.4 For the moderate to large defect associated with an open fracture, the well-vascularized flap can obliterate dead space and deter infection. 1.5 In most cases the donor site can be closed primarily, with minimal morbidity. 2. Based on our clinical experience with 150 patients, the distally based sural island flap can be used reliably for the calcaneal area, malleoli, lower part of the limb, the foot and ankle reconstruction. 3. We believe that the lesser sapheneous vein and deep fascia must be taken with the flap to raise it more safely, however the sural nerve not must be taken with the flap. The flap can be designed anywhere on the suprafascial course of the lesser sapheneous vein on the leg, larger flaps can be taken. Also, skin extension over the pedicle increases safely.