DOI: 10.36347/sjams.2017.v05i03.087

Pages: 1169-1176

To reconstruct defects of the foot and ankle, the first option is free tissue transfer. However, a need of microsurgical expertise and a prolonged operating time remain its disadvantages. In 1992 Masquelet et al., [2] described neuro skin island flaps, distally based sural artery and nerve flaps. The reverse sural artery flap eliminates the need for long and technically demanding free tissue transfers, which have become the gold standard for significant tissue defects in the distal third of the leg and ankle. Unfortunately, the originally described Reverse sural artery flap technique has a risk of partial or total flap necrosis as high as 25%. This risk increases if we extend the flap into proximal part of flap. Preoperative delaying the flap (1 wk to 10 days) may increase the safety & decrease the amount of partial necrosis that commonly occurs with this flap. We conducted this prospective clinical study at Osmania General Hospital from 2013 to 2016. Ten Patients with large, distal most defects of leg, ankle, and foot were taken up into study and reconstruction was done covering the defect with Extended Reverse Sural Flap with pre-operative delay. Ten patients ranged from 20-50 years of age had sustained defects in the distal leg, ankle, heel, foot region resulting from trauma. All wounds healed with favourable functional and aesthetic results without any evidence of major flap necrosis except for 1cm distal necrosis in 1 cases which were managed by debridement and skin grafting. This study conclude that the pre operative delay of Extended Reverse sural artery flap increases the safety of flap and decreases the complication related to Reverse Sural artery flap & also a better alternative to Free flap.