Repeated reverse sural fasciocutaneous flap is an effective surgical strategy for repairing long segmental soft tissue defects of the tibia

Objective This study was performed to introduce our surgical strategy and experience in applying a repeated reverse sural fasciocutaneous flap (RSFF) to repair large areas of tibial exposure. Methods During a 3-year period, 10 patients with a large area of tibial exposure and intact posterior skin and soft tissue after trauma were treated in our hospital using a repeated RSFF. First, most of the area of proximal tibial exposure was covered by an RSFF. Three weeks later, another smaller RSFF was designed from the original flap and rotated to repair the remaining exposed area of the tibial wound. Results All 10 patients' wounds were completely healed after 2 to 4 operations. The wounds had healed well after 6 months. The patients were satisfied in terms of both appearance and function. Conclusion The repeated RSFF is a good treatment strategy for patients with large areas of tibial exposure with intact posterior skin and soft tissue.