Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series

Background: Reconstruction of soft tissue defects around the lower leg, foot and ankle is a challenge for orthopedic surgeons. These defects commonly occur as a result of trauma, infection and tumor excision. Sural artery neurovascular island flap is a relatively thin, pliable and insensate flap wit...

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Autores principales:	Dr Pervaiz Mehmood Hashmi, Abeer Musaddiq, Dr Muhammad Ali, Alizah Hashmi, Dr Marij Zahid, Dr Zohaib Nawaz
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Sural artery flap surgical flap foot and ankle reconstructive surgical procedures wound healing Surgery RD1-811
Acceso en línea:	https://doaj.org/article/11de880f53bd451480b0d937659abcf6
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spelling	oai:doaj.org-article:11de880f53bd451480b0d937659abcf62021-12-02T05:02:02ZLong-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series2352-587810.1016/j.jpra.2021.01.013https://doaj.org/article/11de880f53bd451480b0d937659abcf62021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352587821000656https://doaj.org/toc/2352-5878Background: Reconstruction of soft tissue defects around the lower leg, foot and ankle is a challenge for orthopedic surgeons. These defects commonly occur as a result of trauma, infection and tumor excision. Sural artery neurovascular island flap is a relatively thin, pliable and insensate flap with minimum donor-site morbidity and acceptable aesthetic outcome. Methods: A retrospective analysis of a case series was conducted, all operated by a single surgeon over a period of 25 years from July 1996 to February 2020. Data were collected through a structured proforma; the variables included were as follows: demographic data, mechanism of injury, defect site and size, size of flap, hospital stay, complications, outcome of flap and functional status of limb. Data analysis was performed by using SPSS version 25.0. Results: We included 89 patients out of 106, with 92 distally based sural artery flaps. The flap coverage was divided in two groups: group I for leg (n=41) and group II for foot (n=51). The mean flap dimension in leg was 9.98 ± 2.2 cm and 12.15 ± 3 cm in foot. Postoperatively functional outcomes were assessed using a self-designed tool and graded as excellent in 79 cases (leg=38; foot=41), good in 10 cases (leg=2; foot=8), fair in 3 cases (leg=1; foot=2) and poor in zero cases. All flaps survived uneventfully. Conclusion: The reverse sural artery flap is versatile and reliable, and can be performed easily with good knowledge and using a microsurgical technique. It is useful for the reconstruction of soft tissue defects around the lower third of the leg, dorsum of the foot, malleoli and hind foot. The functional range of motion of the ankle is not compromised because of the flap's supple and pliable nature. The reverse sural artery flap is ideal for the coverage of the foot, ankle and lower one third of the leg. This flap is insensate and not suitable for the weight-bearing area of the heel.Dr Pervaiz Mehmood HashmiAbeer MusaddiqDr Muhammad AliAlizah HashmiDr Marij ZahidDr Zohaib NawazElsevierarticleSural artery flapsurgical flapfoot and anklereconstructive surgical procedureswound healingSurgeryRD1-811ENJPRAS Open, Vol 30, Iss , Pp 61-73 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sural artery flap surgical flap foot and ankle reconstructive surgical procedures wound healing Surgery RD1-811
spellingShingle	Sural artery flap surgical flap foot and ankle reconstructive surgical procedures wound healing Surgery RD1-811 Dr Pervaiz Mehmood Hashmi Abeer Musaddiq Dr Muhammad Ali Alizah Hashmi Dr Marij Zahid Dr Zohaib Nawaz Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series
description	Background: Reconstruction of soft tissue defects around the lower leg, foot and ankle is a challenge for orthopedic surgeons. These defects commonly occur as a result of trauma, infection and tumor excision. Sural artery neurovascular island flap is a relatively thin, pliable and insensate flap with minimum donor-site morbidity and acceptable aesthetic outcome. Methods: A retrospective analysis of a case series was conducted, all operated by a single surgeon over a period of 25 years from July 1996 to February 2020. Data were collected through a structured proforma; the variables included were as follows: demographic data, mechanism of injury, defect site and size, size of flap, hospital stay, complications, outcome of flap and functional status of limb. Data analysis was performed by using SPSS version 25.0. Results: We included 89 patients out of 106, with 92 distally based sural artery flaps. The flap coverage was divided in two groups: group I for leg (n=41) and group II for foot (n=51). The mean flap dimension in leg was 9.98 ± 2.2 cm and 12.15 ± 3 cm in foot. Postoperatively functional outcomes were assessed using a self-designed tool and graded as excellent in 79 cases (leg=38; foot=41), good in 10 cases (leg=2; foot=8), fair in 3 cases (leg=1; foot=2) and poor in zero cases. All flaps survived uneventfully. Conclusion: The reverse sural artery flap is versatile and reliable, and can be performed easily with good knowledge and using a microsurgical technique. It is useful for the reconstruction of soft tissue defects around the lower third of the leg, dorsum of the foot, malleoli and hind foot. The functional range of motion of the ankle is not compromised because of the flap's supple and pliable nature. The reverse sural artery flap is ideal for the coverage of the foot, ankle and lower one third of the leg. This flap is insensate and not suitable for the weight-bearing area of the heel.
format	article
author	Dr Pervaiz Mehmood Hashmi Abeer Musaddiq Dr Muhammad Ali Alizah Hashmi Dr Marij Zahid Dr Zohaib Nawaz
author_facet	Dr Pervaiz Mehmood Hashmi Abeer Musaddiq Dr Muhammad Ali Alizah Hashmi Dr Marij Zahid Dr Zohaib Nawaz
author_sort	Dr Pervaiz Mehmood Hashmi
title	Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series
title_short	Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series
title_full	Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series
title_fullStr	Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series
title_full_unstemmed	Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series
title_sort	long-term clinical and functional outcomes of distally based sural artery flap: a retrospective case series
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/11de880f53bd451480b0d937659abcf6
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Long-Term Clinical and Functional Outcomes of Distally Based Sural Artery Flap: A Retrospective Case Series

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