The Effects of Modified Design of the Reverse Superficial Sural Artery Flap / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To access the efficacy of a modified design of a reverse superficial sural artery flap (RSSAF) to decrease the level of venous congestion and flap necrosis. MATERIALS AND METHODS: Twenty four cases of RSSAF were performed. The mean age of the patients was 47 years and the mean follow up period was 21 months. The average size of the flap was 7.4x5.2 cm. There were 19 cases of the modified flap design and 5 cases of non-modified design. The venous congestion and complications were analyzed according to the modification of the flap design. RESULTS: The flap survived in 23 cases. Primary closure of the donor site was performed in 11 cases whose flap width was <5 cm, and 12 cases required a skin graft. Venous congestion was observed in 5 cases including 4 cases, who were not treated with the modified design and 1 case with arterosclerosis obliterans preoperatively. Partial flap necrosis occurred in 2 flaps that did not have the modified design. CONCLUSION: The modified RSSAF with a skin extension over the pedicle to decrease the tension of the tunnel is an effective procedure for reconstructing the lower extremity, which can prevent venous congestion and improve the survival rate of the flap.