Reverse sural flap as an alternative to microsurgical reconstruction of extensive foot wound after electrical burn: case report

ABSTRACT

Introduction:

To present a reverse sural flap case report as an alternative to microsurgical flap in foot reconstruction after electrical trauma. The report presented is of a patient treated by the Burns and Complex Wounds groups of the Plastic Surgery Service of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo in 2020.

Case Report:

Male patient, 35 years old, without comorbidities, victim of high voltage electrical trauma (1300V) at home, affecting upper and lower limbs bilaterally. Due to the severity of the injuries, he underwent left transtibial amputation and serial debridement in the contralateral limb, resulting in a defect in the medial face, hallux and entire dorsum of the right foot, with bone exposure. Due to the failure of reconstruction with a microsurgical flap of the vastus lateralis muscle, reconstruction with a reverse sural flap was chosen. It evolved with distal necrosis, requiring new debridement and re-advancement of the flap. In the follow-up, he presented a favorable evolution and is in the process of rehabilitation.

Conclusion:

The reverse sural flap proved to be suitable for the salvage treatment of extensive foot injuries after the failure of microsurgical therapy, offering stable coverage and excellent contour, thus allowing satisfactory patient rehabilitation.

Keywords:
Burns; Wounds and injuries; Surgical flaps; Reconstructive surgical procedures; Wound closure techniques; Tissue transplantation.