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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(01): 031-038
DOI: 10.1055/s-0042-1760094
Original Article

Sural Artery as a Recipient Vessel for Free Flaps

Prakash Panagatla
1   Department of Plastic and Reconstructive Surgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
,
Parvathi Ravula
1   Department of Plastic and Reconstructive Surgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
,
Patnala Chandrashekar
2   Department of Orthopaedic Surgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
,
R. Srikanth
1   Department of Plastic and Reconstructive Surgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
,
Nakka Alekya
1   Department of Plastic and Reconstructive Surgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
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Abstract

Introduction The axial vessels like the anterior and posterior tibial emerge as the first choice of recipient vessels, in free flaps for lower limb trauma. When the defects are located more proximally in the leg, the deeper course of the axial vessels makes the dissection more tedious. Alternative vessels like the descending genicular, medial genicular, and distal end of the descending branch of the lateral circumflex femoral can be used for an end-to-end anastomosis, well away from the zone of trauma.

The objective of this study was to define the indications and technique of the use of the sural vessels as the recipient pedicle for proximal and middle third leg defects.

Patients and Methods For the period 2006 to 2022, 18 leg defects following road traffic accidents were covered with latissimus dorsi muscle flap using sural vessels as the recipient pedicle.

Results Among 18 patients, 8 patients had defect in proximal third, 8 had a combined defect in proximal and middle third leg, and 2 had defect in middle third leg. Two patients developed arterial thrombosis and one patient had venous thrombosis for which re-exploration was performed. Two flaps were lost and sixteen had successful wound coverage.

Conclusion The sural vessels as recipient pedicle are easier to access and can be considered as a reliable option for free flaps in limb defects of proximal and middle third leg. Using the submuscular part of the vessel ensures a better distal reach of the flap.

Keywords

free flap - lower limb trauma - sural vessels - leg defects - recipient vessel


Publikationsverlauf

Artikel online veröffentlicht:
07. Februar 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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