Objective: To share our experience on managing distal lower limb tissue defects secondary to burn injury using the distally-based sural artery flap.
Method: Management of certain defects to the ankle and foot can be challenging for the plastic surgeon often requiring free flap reconstruction. The sural artery flap is a distally-based fasciocutaneous flap that has many advantages to offer for coverage of this area. This flap is raised on the posterior aspect of the calf and is supplied by the superficial sural artery that accompanies the sural nerve.
We report our experience with 3 cases: a patient with bilateral foot defects following an electrical burn injury in the acute phase and two patients with chronic heel defects as a result of long burns unit hospitalisation.
Results: All 4 flaps survived without any major complications and minimal donor area morbidity. In the follow up examination all patients were ambulatory without exhibiting any ulcerations or functional deficits.
Discussion / Conclusion: The distally based superficial sural artery island flap is a versatile, reliable procedure useful in reconstruction of the calcaneal area, malleoli and lower part of the limb.This flap not only provides an alternative to microsurgical reconstruction but can also be the first procedure of choice in selected cases.

Distally based sural artery flap for acute and delayed postburn defects