Objective To report the clinical result of the improved island skin flap with distally-based sural nerve nutrient vessels in repairing skin defect in the heel, ankle or foot.

Objective To investigate the effects of different management of superficial vein trunk on distal pedicle flaps.

The injury of proximal part of the avulsed skin flaps gradually renovated, while the distal part degenerated and became necrobiosis after injury.