Reverse Sural Fascio-Cutaneous Flap for Management of Patients with Distal Third of Lower Limb Soft Tissue Defects Referring to the Emergency Department Following Traumatic Events; A Review of 13 Cases
Introduction: Soft tissue defects over the distal leg and/or heel are probable injuries that need a flap. Various coverage techniques have been described in this regard. It seems that applying Reverse Sural Fascio-Cutaneous Flap (RSFCF) for reconstructing soft tissue defects of lower limbs has superiorities over other techniques. Objective: We intend to present a case series with soft tissue defect over the distal third of lower limb, covered using RSFCF technique. Methods: This is a case series and longitudinal study in which patients with crush injuries who referred to the emergency department (Sina hospital, Tehran, Iran) from 2013 until 2020 and were treated with RSFCF technique were included. The data were collected using patients’ charts, by interviewing the patients, and from hospital records. The patients' wounds were prepared, examined, and the surgery was done. Tendon and bone defects were repaired, and wounds were closed using reverse sural Fascio-Cutaneous Flap. Results: A total of 13 patients were eligible during the 6-year study period. Men were more commonly affected with no conclusive gender trend. The posterolateral part of the foot of the right leg was the most frequently injured part (53.8%). Only 1 patient had mentioned complications after surgery including mild congestion and abnormal sensory and motor examination. Patients were followed by the surgeons until 3 months after the operation and all of them had been able to resume their daily life activities by then. Conclusion: According to our findings, almost all of the patients (except one) had received their flaps without any complications. All the patients had been able to resume their daily life activities three months after the surgery. This may show that RSFCF, which can be quickly performed and does not need microsurgical skills, could be a suitable option for the coverage of distal third of lower limb soft tissue defects caused mainly by trauma.
2. Masquelet A, Romana M, Wolf G. Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience in the leg. Plast Reconstr Surg. 1992;89(6):1115-21.
3. Assi C, Samaha C, Chamoun Moussa M, Hayek T, Yammine K. A comparative study of the reverse sural fascio-cutaneous flap outcomes in the management of foot and ankle soft tissue defects in diabetic and trauma patients. Foot Ankle Spec. 2019;12(5):432-8.
4. Sugg KB, Schaub TA, Concannon MJ, Cederna PS, Brown DL. The reverse superficial sural artery flap revisited for complex lower extremity and foot reconstruction. Plast Reconstr Surg Glob Open. 2015;3(9): e519.
5. Ciofu R, Zamfirescu D, Popescu S, Lascar I. Reverse sural flap for ankle and heel soft tissues reconstruction. J Med Life. 2017;10(1):94-8.
6. Turan K, Tahta M, Bulut T, Akgün U, Sener M. Soft tissue reconstruction of foot and ankle defects with reverse sural fasciocutaneous flaps. Rev Bras Ortop. 2017;53(3):319-22.
7. Basile A, Stopponi M, Loreti A, de Simeonibus AUM. Heel coverage using a distally based sural artery fasciocutaneous cross-leg flap: report of a small series. J Foot Ankle Surg. 2008;47(2):112-7.
8. Ajmal S, Khan MA, Khan RA, Shadman M, Yousof K, Iqbal T. Distally based sural fasciocutaneous flap for soft tissue reconstruction of the distal leg, ankle and foot defects. J Ayub Med Coll Abbottabad. 2009;21(4):19-23.
9. Tessler O, Lin AM, Patel S, Dupin CL. Reconstruction Options for Trunk and Extremity Melanoma. Melanoma: Springer; 2018. p. 411-24.
|Issue||Vol 5 No 3 (2021): Summer (July)|
|Lower Extremity Soft Tissue Injuries Surgical Flaps Wound Closure Techniques|
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