• Naser Mozafari, S Mehdi Moosavizadeh, and Mehdi Rasti.
• Plastic and Reconstructive Surgery, Shahid Beheshti Medical University, 15 Khordad Hospital, Iran.
• Burns. 2008 May 1; 34 (3): 406-11.

ObjectiveDebridment of fourth degree burn wound usually leads to soft tissue loss. If these wound are on distal one-third of lower leg and ankle, a simple wound changes to a complex problem. Options are available for these conditions, but each of them have advantages and disadvantages. The distally based neurocutaneous sural flap is one recent flap available for this problem which has excellent results and decreased disadvantages.MethodsBetween 2000 and 2004, all patients with acute fourth degree burns or unstable scar on the distal third of lower leg, foot or ankle that referred to our hospital were scheduled for reconstruction by sural flap. The success rate and ability of the flap to create stable durable coverage at these sites were evaluated.ResultsFifteen patients from 1.5 to 75 years old were included to this study. We had excellent result with this type of flap in 14, we had 100% success rate without necrosis. Only in one patient (a 75 years old man with a history of diabetes mellitus) we had a 0.5cm necrosis of distal margin of flap which healed completely after one session of debridement. All patients were completely satisfied with this flap.ConclusionBecause of few drawbacks of this flap and high success rate and relative simple operative technique, we recommend sural flap as a prime option for repair of fourth degree burn, at distal leg, foot and ankle.

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