Mamoon Rashid, Tahir Masood, Shahid Hameed, Saad ur Rahman Sarwar.
Superficial Sural Artery Flap: A simple solution for difficult heel defects.
J Coll Physicians Surg Pak Jan ;11(5):319-23.

Objective: The management of soft tissue defects over the Achilles tendon, malleoli and heel remains a challenge to plastic surgeons. Skin grafts are not suitable and donor sites for local flaps are limited. Free muscle transfer poses numerous technical difficulties. The objective of this study is to evaluate the efficacy of sural artery flap for hind foot defects in our population. Design: A prospective study was conducted on patients who presented with soft tissue defects of the heel and ankle area. Place and Duration of the study: The study was conducted at the Department of Plastic and Reconstructive Surgery, Combined Military Hospital, Rawalpindi, over a four-year period (August 1995 to January 2000). Subject and Methods: Twelve patients with hind foot defects, which required flap coverage, were include. Preoperative data was recorded and photographs were taken. A distally-based superficial sural artery flap was used in all patients. Pre-operative flap dimensions were recorded and photographs taken. Follow-up was carried out keeping in view the flap survival, functional outcome and donor site morbidity. Results: Out of twelve patients there were ten males and two females aged 12 to 60 years. Most of them had defect due to trauma except 02 that had soft tissue loss following tumor excision. The mean dimensions of the flaps used were 7 x 8.7cm. Postoperatively 10 flaps survived completely while marginal necrosis was seen in two patients and the donor site morbidity was not severe. All patients were ambulatory in normal footwear after this procedure. Conclusions: The distally-based superficial sural artery neurocutaneous flap is a single stage, quick, easy and safe reconstructive option in our patients with hind foot defects.

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