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J Foot Ankle Surg. 2018 Jul - Aug;57(4):833-837. doi: 10.1053/j.jfas.2017.11.018. Epub 2018 Apr 6.

Thirteen-Year Follow-Up Reverse Sural Artery Flap for Plantar Calcaneal Wound: A Case Report.

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Resident Surgeon, Yale New Haven Hospital, New Haven, CT. Electronic address:
Assistant Professor, Department of Surgery, Anesthesia and Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT.


Reconstruction of soft tissue defects in the lower leg and foot after traumatic injury is a challenging problem owing to lack of locally reliable flaps. The traditional options for wound coverage often do not provide feasible or adequate treatment for many of these wounds. The lack of skin laxity in the lower leg and foot often make local flaps unavailable. Split-thickness skin grafts will not be robust enough. Free tissue flaps have a litany of potential complications and guaranteed comorbidities. The present case reinforces that appropriately selected patients with significant open bony and soft tissue trauma to the foot and ankle can be treated with a reverse sural artery fasciocutaneous flap. The reverse sural artery flap allows for full-thickness skin coverage with its own blood supply, maximizing the healing potential and should be considered a viable first option for soft tissue coverage.


closure; expert opinion; heel; reverse sural flap; skin flap; trauma

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