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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(02): 159-165
DOI: 10.1055/s-0043-1760828
Original Article

Empirical Evidence on the Reliability of Lateral Supramalleolar Flap over Reverse Sural Flap for Local Soft Tissue Coverage of Dorsum of the Foot and Ankle Defects

Krishndhari Shankar Jaiswal
1   Department of Plastic, Reconstructive and Burns Surgery, SMS Hospital, Jaipur, Rajasthan, India
,
Samarth Gupta
1   Department of Plastic, Reconstructive and Burns Surgery, SMS Hospital, Jaipur, Rajasthan, India
,
Pradeep Goil
1   Department of Plastic, Reconstructive and Burns Surgery, SMS Hospital, Jaipur, Rajasthan, India
,
Arbab Mohammad
2   Aarupadai Veedu Medical College and Hospital, Puducherry, India
,
Prateek Gupta
1   Department of Plastic, Reconstructive and Burns Surgery, SMS Hospital, Jaipur, Rajasthan, India
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Abstract

Background Soft tissue coverage of the distal foot and ankle region has been an area of debate due to the paucity of local flap options. To provide empirical evidence on the reliability of an underreported local alternative for foot and ankle defects, we aim to compare the lateral supramalleolar flap (LSMF) to the reverse sural flap (RSF).

Methods During 2016–2019, 48 patients were divided randomly into two equal groups, LSMF and RSF groups respectively. The patients' demographic, surgical, and clinical outcome details were recorded and analyzed.

Results Flap necrosis was found in five patients in the group treated with RSF and none in the LSMF group. The mean total number of stages in RSF group was significantly higher than in LSMF group (p < 0.05). The mean operative time for patients in LSMF group was 85.8 ± 18.5 and 54.2 ± 11.2 in RSF group (p < 0.05). Five patients in the RSF group needed additional procedures following flap complications. Nine patients in the LSMF group reported satisfaction outcomes to be “excellent,” five patients reported “good” whereas, in the RSF group, 14 patients reported “excellent,” 5 reported “good,” 3 reported “fair,” and 2 reported “poor” outcomes. Compared to the RSF (46.4 ± 4.3) group, the LSMF group had significantly better foot function indices (34.03 ± 3.9).

Conclusion The lateral supramalleolar flap for foot and ankle defects offers better results, reduced complications as well a lesser number of stages and secondary procedures over the traditionally used reverse sural flap.

Keywords

foot defects - lateral supramalleolar flap - reverse sural flap - distal leg - fasciocutaneous flap

Authors' Contributions

Conceptualization: all authors; data curation: all authors; formal analysis: all authors; funding acquisition: none; investigation: all authors; methodology: all authors; project administration: all authors; resources: all authors; software: all authors; supervision: K.S.J., P. G., S. G.; validation: all authors; visualization: all authors; writing – original draft: all authors, review & editing: all authors.


Note

This article has not been presented in any regional, national or International conferences/meetings.




Publication History

Article published online:
21 February 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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