Abstract

Soft-tissue defects of the heel and dorsal foot are difficult to reconstruct because of scant padding, continuous pressure and high cosmetic requirements. We report two cases managed with the lateral supramalleolar flap at Ha Dong General Hospital. The flap, nourished by a perforator of the peroneal artery, offers a reliable blood supply, generous arc of rotation and eliminates the need for microsurgical facilities. Case 1 involved a dorsal-foot defect; case 2, a heel defect. After thorough debridement, flaps were elevated in the subfascial plane, pivoted around the perforator and inset without tension; donor sites received split-thickness skin grafts. Both patients wore light compression dressings, began early mobilisation and were followed for 3–6 months. Outcomes showed 100 % flap survival, rapid wound healing, no major necrosis or infection, and restoration of independent ambulation. Scars were pliable with acceptable colour match, and functional as well as aesthetic results were rated good by surgeons and patients alike. Average operative time was 85 minutes. The lateral supramalleolar flap therefore represents a simple, safe and cost-effective solution for covering complex distal lower-limb defects when free flaps are contraindicated or unavailable, especially in centres with limited reconstructive resources.