Reconstruction of Achilles Tendon Skin Defect Using Single-Stage Reverse Sural Artery Island Flap

Wound complications following open repair of a ruptured Achilles tendon are common and require immediate skin cover. This study analyses the use of a reverse sural artery island flap to cover skin defects over an exposed intact Achilles tendon. Thirteen patients with postoperative wound complications over the tendoachilles were operated upon. All wounds were debrided and reconstructed with a single-stage reverse sural artery island flap. Within 5 weeks of flap cover, 12 wounds healed completely, while 1 flap had superficial necrosis at the margin in a diabetic patient. This eventually healed and did not compromise the final result. None of the flaps had venous congestion. In our hands, reconstructing skin defects following wound complications after Achilles tendon repair with islanded reverse sural artery flap is a reliable and safe option. Level of Evidence: Level IV.