DOI: https://doi.org/10.36347/sasjs.2025.v11i05.021

Pages: 562-567

Background: Soft tissue defects in the distal leg, ankle, and foot pose significant reconstructive challenges. The extended reverse sural flap (ERSF) offers a local option without microsurgical expertise. This study evaluates its outcomes in a Bangladeshi population with post-traumatic defects. Objective: This study aimed to assess the demographic and clinical profile of patients undergoing ERSF for distal lower limb defects. Methods: A prospective interventional study was conducted in the Department of Plastic Surgery, Dhaka Medical College Hospital, Bangladesh, from January 2012 to June 2013. Sixteen patients with post-traumatic defects (due to machinery injuries, road traffic accidents, and burns) were enrolled via purposive sampling. Data on demographics, defect characteristics, surgical outcomes, and complications were collected and analyzed using MS Office tools. Results: The study of 16 patients (87.5% male, mean age 38.25±11.84 years) revealed trauma (56.2%), malignancy (18.8%), infection (18.8%), and burns (6.2%) as primary etiologies. Defects predominantly involved the heel/sole (56.2%), averaging 6.5×4.5 cm, with 75% exposing vital structures. The extended reverse sural flap achieved 87.5% survival, with complications including venous congestion (18.8%) and infection (6.2%). Radiological findings showed fractures/osteomyelitis in 12.4% of cases. Conclusion: This study delineates the characteristic profile of patients requiring extended reverse sural flap reconstruction, predominantly young males with post-traumatic ankle and foot defects. The findings validate this technique as particularly suitable for moderate soft tissue losses in weight-bearing areas, while highlighting its clinical effectiveness within our patient demographic.