{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:52:32Z","timestamp":1790351552009,"version":"4.1.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"vor","delay-in-days":2742,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:p>\n          Background  The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot.<\/jats:p><jats:p>\n          Methods  The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve.<\/jats:p><jats:p>\n          Results  From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle.<\/jats:p><jats:p>\n          Conclusions  The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.<\/jats:p>","DOI":"10.5999\/aps.2014.41.6.709","type":"journal-article","created":{"date-parts":[[2014,11,5]],"date-time":"2014-11-05T05:44:22Z","timestamp":1415166262000},"page":"709-715","source":"Crossref","is-referenced-by-count":14,"title":["Distally Based Sural Artery Adipofascial Flap based on a Single Sural Nerve Branch: Anatomy and Clinical Applications"],"prefix":"10.1055","volume":"41","author":[{"given":"Wan Loong James","family":"Mok","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Chen","family":"Por","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bien Keem","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,5,5]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1097\/00006534-199206000-00018","article-title":"Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience in the leg","volume":"89","author":"AC Masquelet","year":"1992","journal-title":"Plast Reconstr Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1097\/00006534-199809010-00024","article-title":"Accompanying arteries of the cutaneous veins and cutaneous nerves in the extremities: anatomical study and a concept of the venoadipofascial and\/or neuroadipofascial pedicled fasciocutaneous flap","volume":"102","author":"H Nakajima","year":"1998","journal-title":"Plast Reconstr Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/00006534-199901000-00018","article-title":"Accompanying arteries of the lesser saphenous vein and sural nerve: anatomic study and its clinical applications","volume":"103","author":"H Nakajima","year":"1999","journal-title":"Plast Reconstr Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1093\/ptj\/63.9.1424","article-title":"Limits of two-point discrimination ability in the lower limb in young adult men and women","volume":"63","author":"MF Nolan","year":"1983","journal-title":"Phys Ther"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s10195-012-0202-2","article-title":"The distally based lateral sural neuro-lesser saphenous veno-fasciocutaneous flap: anatomical basis and clinical applications","volume":"15","author":"C Wang","year":"2014","journal-title":"J Orthop Traumatol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"138e","DOI":"10.1097\/01.prs.0000259203.79909.7e","article-title":"The distally based sural flap","volume":"119","author":"KE Follmar","year":"2007","journal-title":"Plast Reconstr Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1097\/00006534-199703000-00022","article-title":"Distally based sural island flap for foot and ankle reconstruction","volume":"99","author":"SF Jeng","year":"1997","journal-title":"Plast Reconstr Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/00006534-199404001-00016","article-title":"The distally based superficial sural artery flap","volume":"93","author":"M Hasegawa","year":"1994","journal-title":"Plast Reconstr Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1055\/s-0028-1090604","article-title":"Maximizing the reliability and safety of the distally based sural artery flap","volume":"24","author":"CH Wong","year":"2008","journal-title":"J Reconstr Microsurg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1097\/PRS.0b013e3182818cd4","article-title":"Anatomy of the sural nerve: cadaver study and literature review","volume":"131","author":"O Riedl","year":"2013","journal-title":"Plast Reconstr Surg"},{"key":"ref11","first-page":"234185","article-title":"Neuropathy dermatitis following surgical nerve injury","volume":"2011","author":"KE Sharquie","year":"2011","journal-title":"Case Rep Dermatol Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/01.sap.0000237741.41510.ff","article-title":"The unstable posterior heel scar: reconstruction using the reverse sural artery adipofascial flap","volume":"58","author":"MM Al Qattan","year":"2007","journal-title":"Ann Plast Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1097\/PRS.0b013e3182589b0e","article-title":"The distally based adipofascial sural artery flap: faster, safer, and easier? A long-term comparison of the fasciocutaneous and adipofascial method in a multimorbid patient population","volume":"130","author":"K Schmidt","year":"2012","journal-title":"Plast Reconstr Surg"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.5999\/aps.2014.41.6.709.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T22:44:41Z","timestamp":1651790681000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.5999\/aps.2014.41.6.709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11]]},"references-count":13,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2022,5,5]]},"published-print":{"date-parts":[[2014,11]]}},"URL":"https:\/\/doi.org\/10.5999\/aps.2014.41.6.709","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11]]}}}