title: Distally based fasciocutaneous sural flap for foot reconstruction: a retrospective review of 10 years experience.
abstract: BACKGROUND
  The treatment of soft tissue defects of the foot is a problem mainly connected to the thickness of the coverage tissues, to the poor circulation, and to the frequent involvement of muscle, tendon, and bone. The authors present their experience with the sural flap, also in some particular cases.
  
  
  METHODS
  The authors treated 33 patients for small- and medium-size defects of the foot, caused by work, home, and road accidents, and by venous or diabetic ulcers. In all cases, the flap was cut in its fasciocutaneous variant; an extension of the sole portion of fascia was added in 5 patients. The flap was transferred under a subcutaneous tunnel in 10 cases, with an open incision in 20 cases, and in 3 cases the pedicle was kept external for 4 weeks, then resected.
  
  
  RESULTS
  One patient showed a complete necrosis of the flap and another showed a superficial necrosis preserving the deep fascia; in the remaining 31 cases, the flap incorporated without any major complication. The flap provided proper coverage of the defects from both an aesthetic and functional point of view as evidenced clinically and through a baropedographic test.
  
  
  CONCLUSIONS
  The advantages of this flap include: dissection is fast and easy, it is not necessary to sacrifice important arterial pedicle or muscular units as it can be used in traumatized limbs without further damage to main arteries, and a wide rotation arc is possible. Disadvantages include the sacrifice of the sural nerve and the covering of the donor region with skin grafts.
authors.affiliation: V. Baretti 4, 10024 Moncalieri, Torino, Italy. marco@fraccalvieri.it
authors.forename: Marco
authors.initials: M
authors.lastname: Fraccalvieri
authors.forename: Paolo
authors.initials: P
authors.lastname: Bogetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Verna
authors.forename: Salvatore
authors.initials: S
authors.lastname: Carlucci
authors.forename: Raffaella
authors.initials: R
authors.lastname: Fava
authors.forename: Stefano
authors.initials: S
authors.lastname: Bruschi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D016523:Foot Ulcer / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation; D013536:Suture Techniques; D020858:Tissue and Organ Harvesting / Q000379:methods*