Innovative Approaches for Unstable Scar Reconstruction: Reverse Sural Flap Technique for Optimal Results

This book chapter presents a case report and discussion on the use of the reverse sural flap in the reconstruction of a post-traumatic unstable scar on the medial aspect of the right ankle. The chapter includes a detailed case presentation, operative procedure, and a comprehensive discussion of the surgical technique, advantages, and limitations associated with the reverse sural flap.

The case presentation describes a patient with a longstanding unstable scar and central ulceration on the medial aspect of the right ankle following a road traffic accident three years prior. Clinical examination confirmed the benign nature of the ulcer and scar. The surgical intervention involved excision of the unstable scar and reconstruction using the reverse sural flap. The dimensions of the defect were measured, and the flap was marked and raised from the posterior calf region. The flap was then transposed to the defect site for reconstruction, and the donor site was grafted with split-thickness skin grafts. The postoperative period was uneventful, and satisfactory results were observed during follow-up examinations.

The discussion section introduces the reverse sural flap as a versatile surgical technique used for the reconstruction of soft tissue defects in the lower leg, ankle, and foot regions. The surgical technique involves patient evaluation and planning, flap design and marking, incision and flap elevation, and flap transposition and closure. The advantages of the reverse sural flap, including adequate tissue volume, vascularized tissue, versatility, and minimized donor site morbidity, are discussed. The limitations, such as technical complexity, potential complications, and donor site aesthetic concerns, are also addressed.

In conclusion, this book chapter provides valuable insights into the use of the reverse sural flap for the reconstruction of soft tissue defects in the lower leg, ankle, and foot regions. Through a case report, operative details, and a comprehensive discussion, the chapter highlights the efficacy, considerations, and potential limitations associated with this surgical technique. This information can guide surgeons in making informed decisions and achieving successful outcomes in the reconstruction of soft tissue defects using the reverse sural flap.