Reverse fasciosubcutaneous flap versus distally pedicled sural island flap: Two elective methods for distal-third leg reconstruction

In case of soft-tissue injury to the distal third of the leg, a safe and ef fective repair technique should be adopted. The use of complex procedures s uch as free flaps and cross-leg flaps is not always advisable. The authors present two methods that have proved to be both reliable and effective in o btaining longlasting satisfactory results: the reverse fasciosubcutaneous s ural flap and the reverse fasciocutaneous island sural flap. Since 1992 the authors have operated on 25 patients affected by traumatic tissue loss of the distal third of the leg and the calcaneal region. They used the fascios ubcutaneous flap in 14 patients and the sural flap in 11. Both of these fla ps are technically simple, safe, and effective, and cause minimal injury to the donor site. The sural flaps are more useful for moderate-size wounds, especially in the calcaneal region, whereas the fasciosubcutaneous flap is better for repairing larger lesions of the leg and the ankle.