Use of expanded reverse sural artery flap in lower extremity reconstruction
Research article published in Journal of foot and ankle surgery (2011)
Abstract
Coverage of defects of the distal third portion of the leg and foot remains a challenge for surgeons. The difficulty results from the limited mobility and availability of the overlying skin, the weight-bearing requirements, and the relatively poor circulation of the skin. From January 2008 to December 2009, 10 patients had defects of the foot and ankle covered using the 2-stage expanded reverse sural flap. Of these 10 patients, 6 had at least 1 risk factor for compromised wound healing, such as diabetes mellitus, peripheral arterial disease, venous insufficiency, tobacco smoking, or age older than 40 years. Flap necrosis was observed in only 1 patient (10%). Venous congestion was noted in 2 patients (20%) by the third postoperative day, 1 of whom responded to postural elevation of the extremity and 1 to medicinal leech therapy. Although it is a 2-stage procedure that requires wound dressing during the expansion, we strongly suggest the use of the expanded reverse sural flap for defects too large to be primarily closed, especially in patients older than 40 years with risk factors such as diabetes mellitus, peripheral arterial disease, or venous insufficiency.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Use of expanded reverse sural artery flap in lower extremity reconstruction.
Why This Matters for Hirudotherapy
The article reports a two-stage expanded reverse sural flap technique for covering distal leg and foot defects in 10 patients, six of whom had at least one risk factor for compromised wound healing. Flap necrosis occurred in one patient (10%), and venous congestion was noted in two patients (20%) by the third postoperative day; one responded to postural elevation and one responded to medicinal leech therapy. This is relevant to ASH's domain because the abstract explicitly documents medicinal leech therapy as a clinical intervention used for venous congestion in a reconstructive flap. The caveat is that leech therapy is mentioned only for one patient, without species, protocol, duration, or outcome detail beyond 'responded to'; the study's main focus is flap technique rather than hirudotherapy.
Citation
Use of expanded reverse sural artery flap in lower extremity reconstruction
Kose AA et al. · Journal of foot and ankle surgery, 2011
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