American Society of Hirudotherapy

Locoregional Flaps in Lower Extremity Reconstruction.

Review published in Clinics in plastic surgery (2021)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsPu · Clinics in plastic surgery, 2021

Abstract

Locoregional flaps play an important role in soft tissue reconstruction of the lower extremity and should be considered an effective option in soft tissue reconstruction. The medial hemisoleus muscle flap and the distally based sural artery flap can be elevated because of unique vascular anatomy and more advanced surgical techniques in flap dissection. Each flap can replace free tissue transfer as the first choice for soft tissue reconstruction of a less extensive wound in the distal third of the leg. Patient selection and detailed knowledge of the flap and its advanced technique for flap dissection are keys to success.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsDissectionHumansLower ExtremityPlastic Surgery ProceduresSoft Tissue InjuriesSurgical Flaps

Summary

Locoregional flaps play an important role in soft tissue reconstruction of the lower extremity and should be considered an effective option in soft tissue reconstruction. The medial hemisoleus muscle flap and the distally based sural artery flap can be elevated because of unique vascular anatomy...

Why This Matters for Hirudotherapy

This review discusses locoregional flap options — particularly the medial hemisoleus muscle flap and distally based sural artery flap — for soft tissue reconstruction of lower extremity defects, emphasizing patient selection and surgical technique. It positions these flaps as alternatives to free tissue transfer for less extensive distal leg wounds. For ASH, there is an indirect connection: reconstructive flap surgery is a clinical setting where medicinal leech therapy is sometimes used to salvage flaps experiencing venous congestion, a known complication. However, the abstract contains no mention of leeches, hirudotherapy, venous congestion management, or any leech-related intervention. CAVEAT: No direct leech content; relevance is limited to the shared clinical context of flap surgery where leech therapy may occasionally play an adjunctive role not addressed here.

Citation

Locoregional Flaps in Lower Extremity Reconstruction.

Pu · Clinics in plastic surgery, 2021

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.