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.
Resumen
Use of expanded reverse sural artery flap in lower extremity reconstruction.
Por qué esto importa para la hirudoterapia
El artículo describe una técnica de colgajo sural reverso expandido en dos tiempos para la cobertura de defectos distales de pierna y pie en 10 pacientes, seis de los cuales presentaban al menos un factor de riesgo de alteración de la cicatrización. La necrosis del colgajo se produjo en un paciente (10%), y se observó congestión venosa en dos pacientes (20%) hacia el tercer día postoperatorio; uno respondió a la elevación postural y uno respondió a la terapia con sanguijuelas medicinales. Esto es relevante para el ámbito de ASH porque el resumen documenta explícitamente la terapia con sanguijuelas medicinales como una intervención clínica utilizada para la congestión venosa en un colgajo reconstructivo. La salvedad es que la terapia con sanguijuelas se menciona solo para un paciente, sin detalle de especie, protocolo, duración ni desenlace más allá de "respondió a"; el foco principal del estudio es la técnica del colgajo, no la hirudoterapia.
Citación
Use of expanded reverse sural artery flap in lower extremity reconstruction
Kose AA et al. · Journal of foot and ankle surgery, 2011
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026