"The Practical Perforator Flap": the sural artery flap for lower extremity soft tissue reconstruction in wounds of war.

Background: Sural artery perforator flaps have been described for use as both local flaps and in free tissue transfer. We present the use of this flap for compound soft tissue defects of the lower limb in civilian casualties of armed conflict in Afghanistan.

Methods/results: Detailed description of the management of blast and high-velocity projectile wounds of the lower extremity with the use of local sural perforator flaps and a review of literature.

Conclusions: Sural artery perforator flaps may be harvested to cover complex lower limb defects. The use of this technique is not limited to centers with complex surgical armamentarium per se, but is feasible for surgeons with good understanding of the local anatomy.