[New cutaneous strategy in sural flap surgery and possibility to adapt this technique to other pedicled flaps]

Introduction: Therapeutic managements in losses of substance of the lower limb using sural flap give an important scar and, sometimes, an impossibility to close the flap donor site. That led us to think about an operative procedure that can reduce those scars without increasing the risk of necrosis of the cutaneous paddle.

Patients and method: We present this operative procedure which underwent in the plastic and reconstructive surgery service in our hospital. Classical flap procedure with two cutaneous parts was used. The cutaneous laxity was evaluated so as to close with one cutaneous part; the other cutaneous part was taken and used like a skin graft after the suture of the calf and the formation of a bursa on the donor site. The leg was closed with only one cutaneous flap.

Results: This technique is illustrated by a case report. Results at the 4th month are very interesting with an acceptable scar and a good result of the skin graft. However, with this technique, we don't decrease the venous risk of this flap. We used this technique for an antebrachial flap.

Conclusion: This technique is an easy and reliable technique based on cutaneous laxity and that decreases scarring of this very useful flap: the neurocutaneous sural flap. We can have a diminution of the number of surgery, a diminution of the scar and good aesthetics results.