Distally based sural neuro-fasciocutaneous island flap to cover tissue loss in the distal third of the leg

The distally based sural neurofasciocutaneous flap is based on the vascular contribution furnished by the arterial network that accompanies the sural nerve and on its neurocutaneous perforating branches. This flap provides a solution that can be effectively used for various reconstructions in the distal third of the lower extremity, thus offering a valid alternative to solutions involving microsurgical repair. The main advantages of this flap are the need for a single operation, limited donor area morbidity, and the structural characteristics of the soft tissue of the flap, which makes it ideal for covering defects in this region. The authors present their clinical experience using this technique.