Technical refinement of the lateral supramalleolar flap.

The lateral supramalleolar flap has proved to be versatile for managing a variety of skin defects of the foot, ankle and lower third of the leg. An anatomical study has shown the reliability of a subcutaneous vascular network, supplied by terminal branches of the perforating branch of the peroneal artery. Our technical refinement consists in designing the skin flap more proximally on the lateral aspect of the leg, and mobilising it on its vascular fascio-subcutaneous pedicle. The flap provides considerable possibilities for covering more distal skin defects of the lower extremity.