A Study on the Versatility and Outcome of Lateral Supramalleolar Flap in Lower One Third of Leg, Ankle, and Foot Defects: A Case Series

Background- Reconstruction of soft tissue defects in the lower one third of leg is technically challenging due to its lack of subcutaneous tissue, poor vascularity, presence of bony prominences and is often susceptible to exposure of superficial tendons, nerves, and vessels. It takes a longer time to develop granulation tissue. Use of skin graft over lower 1/3rd of leg, ankle and foot does not accomplish complete wound coverage. A prospective observational study was Methodconducted in Department of Plastic surgery, Medical College and Hospital, Kolkata for a period of 1.5 years on the patients coming to Plastic surgery OPD with wounds over lower 1/3rd of leg, ankle and foot and requiring coverage by lateral supramalleolar flap were included in this study. Location and length of defects, planning of flap according to defect size, location, operating time, aesthetic acceptance by the patient were some of the parameters studied. Results– Total 9 patients were included in the study fulfilling the inclusion criteria. Apart from partial skin graft loss in 1 patient and 2 mm flap loss in 1 patient, there was no single incident of complete flap or skin graft loss, congestion leading to necrosis or hematoma in any patient. The distally based peninsular flap proved to be beneficial as the flap Conclusionharvesting was less time consuming and covered various defects of different sizes and etiology of the lower 1/3rd of leg & ankle. The complications were minimal with most patients and limited duration of hospital stay.