Non-microsurgical bipedicled reverse sural fasciocutaneous flap with preservation of medial and lateral sural cutaneous nerve: Current surgical management of skin defect after traumatic Achilles tendon rupture – A case report

INTRODUCTION: The challenging issue that still remains for reverse sural flap is the withstand of the flap against time, the width of coverage area, and the donor site morbidity such as pain after the medial or lateral sural cutaneous nerve harvested. PRESENTATION OF CASE: A 55 years old male was suffered from traumatic Achilles tendon rupture for 3 months and was repaired with Krakow's technique in a medical center in Pemalang, Indonesia. After the surgery, the defect was revealed as another surgery was planned to cover the skin defect. The author had chosen the bipedicled reverse sural fasciocutaneous flap in regular basis which addressed the superiority and viability of the flap, thus the donor site morbidity was also concerned as the preservation of medial and lateral sural cutaneous nerve, which leading to good quality of life as the patient still could feel and sensate his medial and lateral leg. DISCUSSION: The bipedicled reverse sural fasciocutaneous flap was successfully covered the skin defect on post traumatic Achilles tendon reconstruction, with retained medial sural nerve on its place, and the remaining harvested skin area was leave opened without skin graft which healed spontaneously. CONCLUSION: Bipedicled reverse sural fasciocutaneous flap with retained medial sural nerve offer a good clinical outcome either the viability of the flap and the maintained sensation along the medial and lateral sural cutaneous nerve distribution.