title: A modified technique for transposition of the reverse sural artery flap.
abstract: BACKGROUND
  Coverage of a soft-tissue defect of the lower third of the leg is a difficult problem. The reverse sural artery flap, first described by Masquelet, is a random type of flap, based on the superficial sural artery.
  
  
  METHODS
  We treated 10 patients with 11 reverse sural artery flaps. A modification of flap transposition through a subcutaneous tunnel with the aid of a soft-tissue expander was described to prevent venous congestion, especially in longer tunnels, for flap insetting.
  
  
  RESULTS
  Eight flaps survived completely. Distal tip and partial skin necrosis was observed in three flaps in two diabetic patients (27.2 percent). No venous congestion was observed after this modification.
  
  
  CONCLUSIONS
  The reverse sural artery flap is a reliable alternative for small to moderate size defects and can be used with modifications of the original technique.
authors.affiliation: Department of Orthopedics and Traumatology, Kocaeli University School of Medicine, Derince, 41900 Kocaeli, Turkey. leventbuluc2001@yahoo.com
authors.forename: Levent
authors.initials: L
authors.lastname: Buluç
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Tosun
authors.forename: Cenk
authors.initials: C
authors.lastname: Sen
authors.forename: Ahmet Ylmaz
authors.initials: AY
authors.lastname: Sarlak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D015626:Tissue Expansion; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery