Objective. Analysis of closure of multicomponent distal defects of the lower extremity with a sural flap on the peripheral pedicle.

Material and methods. We have analyzed 21 cases of closure of deep wound defects of the lower extremity with a sural flap on the peripheral leg. There were 19 men (90.5%) and 2 (9.5%) women aged 39.6±4.7 (18-58) years. The causes of defects were high-energy mechanical injuries — 8 (38.1%), gunshot explosive wounds — 9 (42.9%), complications of osteosynthesis — 2 (9.5%), complications of the Achilles tendon suture — 2 (9.5%). Defects of distal third of the leg (anterior 2/3 of the circumference) were observed in 9 (42.9%) patients, ankle joint — 4 (19.0%), region of Achilles tendon — 2 (9.5%), heel area (back and plantar surface) — 4 (19.0%), middle and forefoot — 2 (9.5%). Fractures occurred in 16 (76.2%) cases.

Results. Surgery time was 127±18 (65-175) minutes without significant between-group differences. Intraoperative blood transfusions were not performed. Successful closure of the wound defects was achieved in 20 (95.2%) cases. In the control group, venous insufficiency on the 2nd-3rd postoperative day was diagnosed in 4 (44.4%) patients. Subtotal flap necrosis occurred in 1 case. In the second group, venous congestion was noted in 2 (16.7%) patients with regional necrosis in 1 (8.3%) of these patients.

Conclusion. Elongated fasciocutaneous pedicle of the flap can reduce the risk of possible complications and improve postoperative outcomes.

Keywords. lower limb, wound defects, plasty, sural flap, complications