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Purpose <p>To compare outcomes of standard and supercharged reverse sural artery flap (RSAF) for lower extremity reconstruction and define indications for each technique.</p> Methods <p>Retrospective single-centre study of 63 patients (2013–2025) : 57 standard RSAFs (group C) and 6 supercharged RSAFs (group S). Primary endpoint : complete flap survival (absence of grade B, C or total necrosis). Secondary endpoints : partial necrosis grading, venous congestion, directed bleeding, hirudotherapy, and surgical revision.</p> Results <p>Complete flap survival was 87.7% (group C) and 100% (group S) (<i>p</i> = 1.000). Venous congestion occurred in 56.1% and 50.0% (<i>p</i> = 1.000). Directed bleeding (22.8%) and hirudotherapy (14.0%) were required in group C versus 0% in group S, where all episodes resolved spontaneously.</p> Conclusion <p>Standard RSAF is a robust, accessible first-line option for non-microsurgeons : 87.7% complete survival with a single total flap loss among 57 cases. Venous supercharging eliminates the need for postoperative venous salvage procedures and should be reserved for very high congestion risk or no viable reconstructive alternative.</p>

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Venous supercharging of the reverse sural artery flap prevents venous salvage procedures : a preliminary 63-case comparative series

  • 期刊论文

  • 发表日期：

    2026年6月1日

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  • Bastien Roche,
  • Théo Lanson,
  • Alexandre Vinel,
  • Vincent Pinsolle,
  • Audrey Michot,
  • Bassel Hoteit,
  • Anaïs Delgove

摘要

Purpose

To compare outcomes of standard and supercharged reverse sural artery flap (RSAF) for lower extremity reconstruction and define indications for each technique.

Methods

Retrospective single-centre study of 63 patients (2013–2025) : 57 standard RSAFs (group C) and 6 supercharged RSAFs (group S). Primary endpoint : complete flap survival (absence of grade B, C or total necrosis). Secondary endpoints : partial necrosis grading, venous congestion, directed bleeding, hirudotherapy, and surgical revision.

Results

Complete flap survival was 87.7% (group C) and 100% (group S) (p = 1.000). Venous congestion occurred in 56.1% and 50.0% (p = 1.000). Directed bleeding (22.8%) and hirudotherapy (14.0%) were required in group C versus 0% in group S, where all episodes resolved spontaneously.

Conclusion

Standard RSAF is a robust, accessible first-line option for non-microsurgeons : 87.7% complete survival with a single total flap loss among 57 cases. Venous supercharging eliminates the need for postoperative venous salvage procedures and should be reserved for very high congestion risk or no viable reconstructive alternative.