UAD Flap: A Contemporary Alternative to the Conventional Sural Flap for Distal Leg Wound Reconstruction.

Background: The reconstruction of soft tissue near the heel area is challenging, especially after wheel-spoke injuries. Different varieties of the reverse sural artery flap technique are routinely used in complex locoregional areas for reconstructive surgery.

Methods: This study proposes an innovative surgical method involving the use of a rotation-advancement fasciocutaneous flap based on peroneal artery perforators. In this study, 30 patients with soft-tissue defects in the lower third of the leg, including defects in the ankle and heel areas, were treated with this flap.

Results: The study included 19 women and 11 men. The mean age of the patients was 27.60 years. The most common cause of the defect was wheel-spoke injury due to a road traffic accident. In the authors' experience, the flap survival rate was approximately 100%. Four patients had only marginal necrosis of the distal tip, and 2 patients had minor wound infections; these patients were managed cautiously until their healing was complete.

Conclusions: For distal leg reconstruction, the authors recommend the UAD flap over the traditional sural flap because of its lower donor-site morbidity and better aesthetic appearance.