To represent our clinical experiences on the use of distally or proximally based sural artery pedicled flap for the treatment of soft tissue defects of the leg, ankle or foot. We expanded the indication for soft tissue coverage using sural artery flap by adding a proximally based sural artery flap to the distally based flap presented previously.

Since 1994, 55 patients with soft tissue defects of the leg, ankle and foot were covered by using sural artery pedicled flaps, proximally based flaps in 7 patients and distally based in 48 patients. The size of the flaps varied from 5 cm wide and 6 cm long to 10 cm wide and 15 cm long.

All of the flaps except one survived. Marginal necrosis of the flap ocurred in 3 cases. Another three cases showed venous congestion during the early postoperative period. Sensibility loss was observed on the dorsolateral aspect of the foot. An unsightly scar was left at the donor site.

The sural artery pedicled flap has a wide variety of indications, and can be used as a good alternative method for soft tissue coverage of small and medium sized soft tissue defects of the leg, ankle or foot. However, donor site morbidities should be considered before surgery.