Increased SuccessRate in Delayed Reverse Sural Artery Flap Author: Dr.A.Kavitha Priya, M.Ch (Plastic)
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 9
Abstract
Background:Soft-tissue defects of the distal third of the lower extremity, ankle and foot present significant challenges to the reconstructive surgeon. The options in this region are limited. The reverse superficial sural artery flap (RSSAF) is a popular option for the defects. Our initial experience with this flap resulted in 50% failure rate, mostly because of critical venous congestion. To overcome this, we have modified our operative technique, which has resulted in a more reliable and increased survival of the flap. Methods:All patients reconstructed were having lower third leg, ankle and foot defects. In response to a high rate of venous congestion in the earlier flaps, we adopted a uniform change in the operative technique .A key modification was to delay the flap both in regular and extended flaps. And we kept the pedicle width of about 4 cm. Results:Twenty one patients were reconstructed with Reverse superficial sural artery flap. Salvage rate in the earlier group was 50% compared with almost 98% in the delayed sural flap cases. Conclusion:Venous congestion greatly impairs the survival of the RSSAF. A pedicle width of at least 4 cm is recommended to maintain venous drainage and preserve flap viability. We observed that the delayed flap had the survival rate of almost 98%.
Authors and Affiliations
Dr. A. Kavitha Priya
Keywords
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- EP ID EP256007
- DOI 10.9790/0853-1609042428
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