Case series of sural island flaps used for soft-tissue defects of the distal-third lower extremity

Objective: To establish the sural island fasciocutaneous flap as an initial consideration for distal third lower-extremity soft tissue coverage and to provide non-plastic surgeons with a procedure they can perform on their own. l Method: Literature on reverse sural island fasciocutaneous flaps was reviewed and summarised. We then assessed our case series of sural island flaps from 2008-2011 and looked to provide our operative technique and patient outcomes. l Results: Nine patients, aged 12-70 years old, with greater than 1 year follow-up, were reviewed. Five patients had diabetes, peripheral vascular disease, or smoked tobacco. All patients healed their soft tissue coverage with minimal complication and were able to accommodate normal footwear. l Conclusion: Reverse sural island flaps are resilient flaps that should be considered as an alternative to free muscle transfer, for distal third lower extremity coverage. l Declaration of interest: There were no external sources of funding for this study. The authors have no conflicts of interest to declare.