Microsurgical techniques can augment the arterial blood supply of a distally based myocutaneous flap, by reanastomosis of the sural artery to a main artery of the leg, allowing the flap a greater length and arc of rotation to cover defects of the distal half of the leg. No venous anastomosis is required. This procedure was used in 17 patients with open tibial fractures. They all healed primarily without any early or late complications. The use of this augmented flap provides a simple and reliable method for reconstruction of difficult wounds of the distal lower leg. It is easier and safer than a free flap.
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