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초록
Purpose:
Soft tissue defects in the distal lower extremity represent a special challenge for reconstructive surgeons. Vari-ous methods of lower-limb wound coverage have been described, such as local flaps, distant flaps, and free flaps. Among various methods, the delayed reverse sural flap can be one of the several options for the reconstruction of distal lower extremity in high-risk patients. We report our experiences with the versatile, delayed reverse sural flap for coverage of the distal lower extremity in high-risk patients.
Methods:
From September 2015 to October 2016, seven patients with soft tissue defects of the distal lower extremity were treated with the delayed reverse sural flap based on a two-step procedure. All patients had significant medical co-morbidities, such as diabetes mellitus, peripheral arterial disease, and smoking. The delay period ranged from 10 to 14 days, and the flap size was from 7.5×2.0 to 14.5×4.0 cm.
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REFERENCES
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 | Fig.1.A case of posterior ankle defect. (A) Defect with exposure of the Achilles tendon. (B) Appearance at 1 week after 2nd stage of operation. (C) Appearance at 6 months postoperatively. |
 | Fig.2.A case of heel defect. (A) Defect with exposure of the calcaneus. (B) Intraoperative photograph; the lesser saphenous vein (black arrow) and the sural nerve (white arrow) were identified in the pedicle. (C) Appearance immediately after 2nd stage of operation. (D) Appearance at 2 days after 2nd stage of operation. Venous congestion was seen. (E) Appearance at 15 months postoperatively. |
 | Fig.3.A case of lateral malleolar defect. (A) Defect with exposure of the lateral malleolus. (B) Appearance immediately after 2nd stage of operation. (C) Appearance at 2 months postoperatively. |
Table 1.
Summary of patient characteristics
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