Supra malleolar flap





Wounds on the heel and back of foot are specially troublesome. Reverse sural flap , free flaps are used to reconstruct it. Supra malleolar flap is a versatile flap to cover these injuries /defects. It is rapid reliable flap for covering medial and lateral arches and entire heel region.

Anatomy 
Vascular supply is by the anastomotic arcade of the ankle. Perforator of peroneal artery anastomose with anterior malleolar artery arising from anterior tibial artery. They give perforator which supply overlying skin. Sinus tarsi is the pivot point of the distal based flap. 




original defect

flap being raised


flap insetted








Dr Adhishwar Sharma
MBBS,MS General Surgery, PGIMER Chd
Mch Plastic Surgery
Fellowship in hand and microvascular surgery
8860650846, adhishwar7@gmail.com










Comments

Post a Comment

Popular posts from this blog

Andy Bump deformity Anterior mandibular reconstruction

Image
Andy gump deformity is loss of anterior mandibular segment due to trauma ,infection or tumor resection. It is named after a famous cartoon character in USA . Best way to reconstruct is to do a microvascular reconstructive surgery. Osteocutaneous fibula is harvested on peroneal vessel , shaped into desired form and transferred. Microvascular anastomosis is done to local available  vessel. Flap is monitored for 5 days .Subsequently patient is discharged  . Tracheostomy if done is removed at day 5.                                                                                                                       At two weeks Fibula with blood vessel vasc...
Read more

Mandibular reconstruction for Osteo Radio necrosis of mandible

Image
  Chin deviation Exposed dead mandible                                       Patient painted and draped                                        Fibula skin paddle marked                                                                   Microvascular anastomosis to contralateral facial vessels  Fibula being plated                                                    Paroneal vessels attached to facial vessels Dr Adhishwar Sharma  MBBS,MS Gen Surgery PGIMER Mch Plastic Surgery Delhi universi...
Read more

Post radiotherapy buccal mucosa cancer excision and reconstruction

Image
Recurrent tumor anterior view surgical team doing resection flap being insetted vessel anastomosis in contra lateral vessel before closure next day ICU reconstructive and onco surgeon in a team to serve patients in best possible way Me with Dr kaushal  post op day 3 A 40 year old male with recurrent squamous cell carcinoma . First surgery was done 5 years back and subsequently patient under went radiotherapy . Radiotherapy is very unforgiving to tissues it becomes hard and stiff. Vessel dissection becomes is difficult or hazardous . Patient was planned for surgery and tumor was excise with adequate margins . Anterior and lateral mandible was reconstructed free fibula flap . Paroneal vessel were connected to contra lateral neck vessels. Dr Adhishwar Sharma MBBS,MS  General Surgery PGIMER Chd Mch Plastic Surgery Fellowship in hand and microvascular surgery brahmanandclinic.com 8860650846
Read more