Abstract
BACKGROUND AND AIM: The sural neurovascular flap has been effectively used to reconstruct complex tibial and soft tissue defects caused by severe trauma, promoting successful wound repair and healing. Proactive management is essential in minimizing postoperative complications and achieving optimal outcomes. This study evaluates the efficacy and long-term outcomes of sural neurovascular flap applications in distal lower limb wound reconstruction. METHODS: Our institution's ethics committee approved this retrospective study numbered YJ202457 involving 47 participants. Informed consent was obtained from all subjects. Data collected included demographic details, injury mechanisms and sites, mode and size of soft tissue defects, complications, cosmetic outcomes, and functional outcomes of the lower limb and ankle. All flaps were performed by a single surgeon, with follow-up from January 2012 to February 2018. RESULT: The study observed minor complications, primarily superficial necrosis. Over 95% (45) of flaps survived, and less than 5% (2) required reoperations due to superficial necrosis. Patient satisfaction was high, with over 50% (24) achieving excellent cosmetic results and over 40% (20) good cosmetic results. The study recorded improved Functional Recovery and Quality of life. CONCLUSION: Sural neurovascular flap applications show significant promise in reconstructing distal lower limb wounds. Our findings highlight the procedure's efficacy, demonstrated by high patient satisfaction, excellent cosmetic outcomes, and favorable functional results. Critical factors for success include meticulous patient selection, thorough debridement, and careful planning to mitigate risks and optimize outcomes. The patients with diabetes and hypertension were not included to minimize factors that could interfere with the study's results.