Distally based fasciocutaneous flap of the calf for cutaneous coverage of the lower leg and dorsum of the foot

Cutaneous injuries of the inferior third of the leg and dorsum of the foot represent a great challenge for plastic surgeons. The poor vascularization and subsequent poor healing encountered in these regions demand detailed kn owledge of the local anatomy to select the best surgical alternative for ea ch patient. In patients in whom local or free muscular flaps are not suitab le, the fasciocutaneous flaps seem to be a good alternative. The distal ped icled fasciocutaneous flap of the calf was used to cover skin defects of th e leg and foot in 22 patients. In 4 patients the authors designed an island flap to prevent a large defect in the donor area and to decrease the time of hospitalization and recovery of the patient. In a severe defect, the fla p was used as a cross-leg flap, The results were satisfactory because the f lap provided stable coverage for different defects with few complications. The island flap is a good option for achieving a better aesthetic result an d can be used in select patients.