The Reverse Sural Artery Flap: A Reliable and Versatile Flap for Wound Coverage of the Distal Lower Extremity and Hindfoot

Clin Podiatr Med Surg. 2020 Oct;37(4):699-726. doi: 10.1016/j.cpm.2020.05.004. Epub 2020 Aug 12.

Abstract

The reverse sural artery flap is a distally based fasciocutaneous or adipofascial flap used for wound coverage of the distal one-third of the lower extremity, ankle, and posterior heel. The flap harvest can be performed without sacrificing major arteries of the lower extremity. It can be elevated and mobilized with relative ease and a short operative time. It provides a good alternative to free tissue transfer in complex lower-extremity wounds with exposed bone, tendon, or hardware. The surgeon must be familiar with the management of venous congestion to improve the success of the flap.

Keywords: Adipofascial; Fasciocutaneous; Flap; Lower limb reconstruction; Traumatic defect.

Publication types

  • Review

MeSH terms

  • Arteries / anatomy & histology
  • Heel / surgery*
  • Humans
  • Lower Extremity / surgery*
  • Saphenous Vein / anatomy & histology
  • Sural Nerve / anatomy & histology
  • Surgical Flaps / blood supply*