Reversed skin island, fascial pedicle flap of posterior calf for distal defects of the leg and foot: an alterative for free flap transfere

This report described a useful distally-based fasciocutaneous skin island, fascial pedicled flap, raised from the posterior calf. The blood supply of the flap depends on three sources: The first is the median sural neurovascular bundle, the second is the most distal septocutaneous perforators of the posterior tibial artery and the third one is the most distal septocutaneous perforators of the peroneal artery. The flap can reach the heel, the ankle region and the hind foot and can be used to cover the distal amputated stumps. The limitation of this flap is the sensory impairment of the lateral foot, but the results are superb considering this limitation. The aim of this study was to corroborate the role of this flap in certain patients avoiding the vagaries of microsurgery. An experience of 16 flaps was presented, where the flap dimension, arc of rotation, strengths and the limitation of the flap were discussed

Reversed pedicled adipofascial flap for coverage distal pretibial soft tissue defects

Reconstruction of the distal pretibial soft tissue defects continue to challenge the reconstructive surgeon. This study reviewed the possibility of the use of reversed pedicle Adipofascial flap based on the distal perforators of both the posterior tibial and peroneal arteries. Ten patients were selected for this study, 7 patients with traumatic defects with fracture tibia, and 3 patients with chronic osteomyelitis associated with chronic unstable scarring. The study also demonstrated the durability of the flap in the presence of these problems