The distally based island superficial sural artery flap: Clinical experience with 36 flaps

The principles of neurocutaneous flaps, first described by Masquelet in 199 2, represented a new concept in skin vascularization, The distally based su perficial sural artery flap is an example of this kind of flap, which is su pplied by the vascular axis that accompanies the sural nerve. The authors t reated 36 patients with 36 distally based superficial sural artery flaps. A ll flaps survived, but six of them exhibited partial necrosis, No patient e xperienced anesthesia of the lateral side of the foot or neuroma at the don or site 12 months after surgery. The authors confirmed that this flap is ve ry useful for soft-tissue reconstruction of the distal third of the leg and foot. Additionally they conclude that the principal advantages are that th e blood supply is reliable, execution is easy and fast, the operation can b e performed under regional anesthesia, the flap has a large are of rotation , direct closure of the donor area is possible for small flaps, major arter ies or nerves are not sacrificed, and excellent durability is achieved, eve n on weight-bearing areas. The major drawback is the donor site scar.