Abstract: Objective: To investigate the effect of the island skin flap with sural nerve nutrient vessels on repairing skin defects in ankle and foot.Methods: Twenty patients with skin defects in ankle and foot were treated by improved island skin flaps with sural nerve nutrient vessels.The flap area ranged from 4 cm×5 cm to 11 cm×10 cm.The donor sites were sutured directly or covered with free flaps.Results: Eighteen flaps survived,and the donor and recipient sites healed well;two cases presented distal necrosis.Twelve cases were followed up for 6 to 12 months;the contour of the flap was satisfactory and the color was similar to that of normal skin;no necrosis occurred.Conclusions: The island skin flap with sural nerve nutrient vessels is an ideal flap for repairing skin defects in ankle and foot.