Distally based sural lesser saphenous neuro-veno-adipo-fascial (NVAF) flap for reconstruction in the foot: Lessons learned

We report nine cases in which the neuro-veno-adipo-fascial (NVAF) flap was used to perform reconstruction of foot wounds over a 7-year period. Complications occurred in five (56%) patients. One patient suffered total loss of the flap and four experienced partial loss of the NVAF flap. Complications are to be expected with the use of the NVAF flap for foot wounds, but in most cases the flap is salvageable. The NVAF flap is an option in foot reconstruction when free tissue transfer is not available, contraindicated due to patient factors or when a prior free flap has failed.