J Reconstr Microsurg 2010; 26(8): 501-508
DOI: 10.1055/s-0030-1261702
© Thieme Medical Publishers

The Proximally Designed Sural Flap Based on the Accompanying Artery of the Lesser Saphenous Vein

Alvaro Baik Cho1 , Pedro Henrique Isoldi Pohl2 , Gustavo Mantovani Ruggiero1 , Márcio Aurélio Aita1 , Thiago Guedes da Motta Mattar2 , Walter Yoshinori Fukushima1
  • 1Division of Hand Surgery and Microsurgery, Hospital Estadual Mário Covas, ABC School of Medicine, São Paulo, Brazil
  • 2Division of Traumatology and Orthopaedic Surgery, Hospital Estadual Mário Covas, ABC School of Medicine, São Paulo, Brazil
Further Information

Publication History

Publication Date:
22 June 2010 (online)

ABSTRACT

Most of the literature about the sural flap deals with soft tissue defects at the lower leg and foot based on the classical description of Masquelet et al. Nevertheless, some authors have shown that the lesser saphenous vein and its accompanying artery play an important role in the vascularization of the posterior skin of the leg. This finding allowed a more proximal design of the flap, increasing its arc of rotation. Thirteen cases of distally based sural flaps were performed and divided in two groups according to the level where the flaps were harvested. In group A, the entire flap was outlined distal to the midpoint of the leg, and in group B, the flap was outlined proximal to the midpoint of the leg. In group A, all the soft tissue defects were located at the lower leg and the foot, and in group B, they involved the anterior the tibia. In group A, the complication rate was 33.33% and the flap survival rate was 83.33%. In group B, the complication rate was 42.85% and survival rate was 100%. The proximally designed sural flap can safely reach the anterior aspect of the tibia in its middle and distal thirds.

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Pedro Henrique Isoldi PohlM.D. 

2nd Year Resident, Division of Traumatology and Orthopaedic Surgery, Hospital Estadual Mário Covas–ABC School of Medicine, Rua Abílio Soares

639 Ap 24 B, Paraíso, São Paulo, SP Cep: 04005-002, Brazil

Email: pedropohl@bol.com.br