Journal Article Comparative Study Epublish
PubMed: 42223697 DOI: 10.1007/s00590-026-04819-6
Venous supercharging of the reverse sural artery flap prevents venous salvage procedures : a preliminary 63-case comparative series.
Eur J Orthop Surg Traumatol 36(1)
Authors: Bastien Roche, Théo Lanson, Alexandre Vinel, Vincent Pinsolle, Audrey Michot, Bassel Hoteit, Anaïs Delgove
Affiliations
- Department of Plastic and Reconstructive Surgery, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
- Department of Plastic and Reconstructive Surgery, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
- Department of Reconstructive and Oncological Surgery, Institut Bergonié, Bordeaux, France.
Abstract
PURPOSE
To compare outcomes of standard and supercharged reverse sural artery flap (RSAF) for lower extremity reconstruction and define indications for each technique.
METHODS
Retrospective single-centre study of 63 patients (2013-2025) : 57 standard RSAFs (group C) and 6 supercharged RSAFs (group S).
PRIMARY ENDPOINT
complete flap survival (absence of grade B, C or total necrosis). Secondary endpoints : partial necrosis grading, venous congestion, directed bleeding, hirudotherapy, and surgical revision.
RESULTS
Complete flap survival was 87.7% (group C) and 100% (group S) (p = 1.000). Venous congestion occurred in 56.1% and 50.0% (p = 1.000). Directed bleeding (22.8%) and hirudotherapy (14.0%) were required in group C versus 0% in group S, where all episodes resolved spontaneously.
CONCLUSION
Standard RSAF is a robust, accessible first-line option for non-microsurgeons : 87.7% complete survival with a single total flap loss among 57 cases. Venous supercharging eliminates the need for postoperative venous salvage procedures and should be reserved for very high congestion risk or no viable reconstructive alternative.
MeSH
Hemorrhage, Arteries, Orthopedics, Necrosis, Wounds And Injuries