Reverse sural artery flap: a reliable alternative for foot and ankle soft tissue reconstruction

  • Anastasios Korompilias
  • Ioannis GkiatasEmail author
  • Maria Korompilia
  • Dimitrios Kosmas
  • Ioannis Kostas-Agnantis



Soft tissue defects of foot and ankle are challenging due to the susceptibility of the area to trauma and the complexity of the region. Several flaps have been described for wound coverage after surgical debridement at this location. The purpose of this study is to present the reverse sural flap for covering soft tissue defects at the ankle and foot.

Materials and methods

From July 2014 to November 2017, ten patients with soft tissue defect at the ankle and foot were retrospectively reviewed. There were nine men and one woman with a mean age of 40.5 years (range 17-71 years). Seven patients were smokers and five were diabetics. The mean size of the defect was 50.5 cm2. All operations were performed by the same microsurgical team. At a mean follow-up of 21 months (range, 18 to 24 months), we evaluated wound healing and complications.


In nine patients, the soft tissue defect was successfully covered. In four patients, venous congestion was noticed, whereas in one patient, there was total necrosis of the flap. In all cases, the donor site was healed uneventfully.


The reverse sural artery flap is a reliable alternative for wound coverage at the ankle and foot, with low complication and morbidity rate. Nevertheless, it is a demanding microsurgical operation that requires knowledge of the anatomy and surgeons' experience.


Soft tissue deficits Reverse sural artery flap Foot and ankle Microsurgery 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Anastasios Korompilias
    • 1
  • Ioannis Gkiatas
    • 1
    Email author
  • Maria Korompilia
    • 1
  • Dimitrios Kosmas
    • 1
  • Ioannis Kostas-Agnantis
    • 1
  1. 1.Department of Orthopaedic SurgerySchool of Medicine, University of IoanninaIoanninaGreece

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