Distally based reverse sural artery flap as an interpolation flap

Srijana Muppireddy, Srikanth R.


Background: Coverage of soft tissue defects of the foot and ankle has imposed a challenging situation to the plastic surgeon. Some patients have contraindications for microsurgery, thus limiting the options for local tissue transfer. The Reverse sural artery flap is frequently used for reconstruction of distal third leg, ankle, and heel. The major disadvantage of RSA flap is compression of pedicle within subcutaneous tunnel leading to venous congestion and distal flap necrosis. To overcome this problem, we describe an interpolation flap technique in which subcutaneous tunneling of neurovascular structures is avoided.

Methods: 13 cases of distally based RSA flaps as interpolation flap were performed for soft tissue defects in dorsum of foot, heel pad, malleoli, and TA region during the period 2014 to 2016.

Results: With this procedure no flap loss was observed in this series and only a few minor complications occurred. The pedicle is divided in a second stage operation.

Conclusions: We conclude that transferring the flap in 2 stages without use of tunnel improves the reliability of flap and decreases the chances of necrosis.


Reverse sural artery, Interpolation, Lower extremity reconstruction

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