Reverse Flow Sural Flap Coverage in Sequel of Electric Burn, Case Report| Stephy Publishers

 



SOJ Orthopaedics and Rehabilitation - (SOJOR)| Stephy Publishers

Abstract

Reconstruction of injuries and defects in the distal third of the lower extremities represents a challenge for the plastic surgeon. The clinical case of a 46-year-old patient with a sequela of electrical burn in the distal third of the leg and the proximal third of the right foot is presented, who underwent skin coverage with a reverse flow sural flap. The treatment performed is described, as well as the surgical technique. We consider that the reverse flow sural flap is an optimal option when evaluating different forms of coverage in lesions of the distal third of the lower extremities, with positive long-term results.

Keywords

Electrical burn, Reconstructive surgery, Sural flap

Introduction

The repair of injuries and defects of the lower limb located in its distal third constitutes a challenge for reconstructive plastic surgery. The research reflected in different bibliographic sources has allowed us to know a variety of procedures to perform the cutaneous coverage of this region, being a great alternative for this defect the reverse flow sural flap.1 Among the most common causes of lower limb defects are high voltage electrical burns (greater than 1000 volts), along with other high-impact traumatic causes, which can lead to death and/or amputation of extremities.2 In an electrical burn, the increased resistance of the bone tissue to the electrical current generates heat and in the most distal region of the extremities, vasoconstriction, thrombosis and progressive ischemic necrosis occur that injure the surrounding muscle tissue, which can cause large defects that are difficult to cover.3 The closure of these defects, caused by an electrical burn, implies a difficulty when selecting the appropriate treatment, since skin grafts are not a reconstructive option, taking into account that the vascular bed of the recipient area in this region is often inadequate, in addition to the need to cover other structures such as: tendons and/or muscles,4 while the perforator flaps of the leg become a better option when it comes to providing coverage, acting at the level of the same member without generating morbidity in another donor area.5 The objective of this work is to present the clinical case of a patient with a defect in his left lower limb, as a result of a high voltage electrical burn, and how this area was covered using the technique of a reverse flow sural flap.

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