Reverse Sural Flap for Distal One Third Tibial Wounds

Description

In this instructional video, Dr. Janet Conway from the Rubin Institute provides a comprehensive overview of performing a reverse sural flap for wound coverage on the lower third of the tibia and foot. Dr. Conway begins by discussing the challenges associated with covering wounds located on the distal tibia and heel due to the lack of viable local muscle flaps. The reverse sural flap, using the vascular supply from the peroneal artery perforators and sural artery, is presented as a popular option in recent years, especially when certain preoperative conditions, such as intact blood flow and no violation of vascular supplies, are confirmed.



Throughout the video, Dr. Conway methodically details the surgical techniques involved in marking, incising, and mobilizing the tissue required for the flap. Attention is emphasized on maintaining vascular integrity to ensure flap survival, particularly in diabetic patients where complications are more likely. The presentation includes specific measurements for the flap, planning based on defect size, and the importance of preserving vascular bundles during dissection.



The video concludes with postoperative care instructions, emphasizing the need for patient immobilization and prevention of pressure on the flap to promote healing. By following the outlined procedures, Dr. Conway aims to offer guidance for achieving successful flap coverage in complex lower extremity wounds.

Specialties