Reverse Sural Artery Flap For Heel Defect

Flap Description

Reverse Sural Artery Flap is Based on Median Sural Artery .

This is a Branch of Lateral Sural Artery.
Others are Medial and Lateral Sural Artery

Lesser saphenous vein accompanies along with Sural nerve.

Procedure

Flap is Marked at a pivot point about 5cm or 3 finger breadth from mid point of the lateral malleous and the tendo achilles.

Up to the popliteal fossa line is drawn.
Only Up to the upper middle 3rd junction the flap is taken .

Artery,nerve and vein are tied at above 1inch from flap incision site.

Up to fascia of muscle flap is included till the pivot point flap raised.

Flap now survives on the perforators communicating with the peroneal artery.

Tips

Avoid kinking and tunnelling of the flap before giving inset to the flap to the defect of the leg.

Flap can also be delayed when one thinks that flap does not survive.