Shrestha, JMRayamajhi, SLohani, IManandhar, KSharma, S2026-04-172026-04-172017https://hdl.handle.net/20.500.14572/5792Shrestha JM, Rayamajhi S, Lohani I, Manandhar K, Sharma S Department of Plastic Surgery and Burns, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, NepalAbstract Introduction: Reverse sural artery flap has been used effectively to cover defects of distal leg, ankle and foot. This flap is easier and quick to harvest and is a versatile flap in terms of extensive mobility and reliable vascularity and, in many instances it has obviated the need for free tissue transfer. Methods: This is a retrospective study of sural flaps done at the Department of Plastic Surgery and Burns in Tribhuvan University Teaching Hospital over a period of 4 years from April 2011 to March 2015. It included 21 flaps carried out in 21 patients with soft tissue defects at distal lower leg, ankle and foot. Results: Among 21 patients, 10 were men and 11 were women with an average age of 41 years (17 – 81). Successful flap coverage was obtained in 16 cases out of 21 (76%) which included 10 cases of complete survival (48%) and 6 cases (28%) of marginal flap necrosis. Four cases (19%) had partial flap loss and one case (5%) lost flap completely. Conclusion: we found that reverse sural artery flap has good reliability with low incidence of complications and is a versatile flap for the reconstruction of defects in distal leg, ankle and foot Key words: sural flap, distal leg, ankle, foot, flap survival, flap necrosis, skin stripen-USsural flapdistal leganklefootflap survivalflap necrosisskin stripArticle