title: Reconstruction of the lower leg with the sural artery flap.
abstract: BACKGROUND
  Soft tissue covering on the lower leg is frequently a difficult challenge and causes increasing problems for treatment in smaller hospitals. We introduce a plastic surgery method for covering these soft tissue defects.
  
  
  METHODS
  An island of skin, centered above the sural nerve, is cut out in the middle dorsal area of the lower leg. The subcutaneous vascular pedicle is prepared along the nerve. The gained skin flap is rotated into the defect site and fixed without tension. The wound of the donor-site defect is usually closed primarily, and the flap pedicle is covered with Meshcraft.
  
  
  RESULTS
  In 18 of the 21 patients treated by this method the flap healed without functional impairment, one patient experienced a necrosis leading to the loss of the flap. And a partial loss of the skin island was recorded in two cases, complete healing was achieved by means of Meshcraft transplantation.
  
  
  CONCLUSIONS
  The superficial sural artery flap usually results in a reliable and complete healing of soft tissue defects within the area of the lower legs with justifiable operational expenditures also for elderly patients and those with vascular ailments.
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Justus-Liebig-Universität Giessen, Rudolf-Buchheim-Strasse 7, Germany. christof.meyer@chiru.med.uni-giessen.de
authors.forename: Christof
authors.initials: C
authors.lastname: Meyer
authors.forename: Bernd
authors.initials: B
authors.lastname: Hartmann
authors.forename: Uwe
authors.initials: U
authors.lastname: Horas
authors.forename: Olaf
authors.initials: O
authors.lastname: Kilian
authors.forename: Christian
authors.initials: C
authors.lastname: Heiss
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schnettler
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D007871:Leg Ulcer / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology