The results of treatment of 36 patients with extensive gunshot defects on the foot and lower leg with the use of a neurovascularized flap on the sural artery have been analyzed. Goal – to investigate the effect of catheterization of the small saphenous vein, which is included in the flap, on the frequency of development of its ischemic complications. The 1st group (n=14) included the wounded, who underwent complex treatment of an extensive gunshot defect followed by its plasticity with a “sural flap” with temporary catheterization of the small subcutaneous vein included in its composition. The 2nd group (n=23) included patients who, after complex treatment of an extensive gunshot defect, underwent plastic surgery with a “sural flap” without catheterization of the vessels included in it. In case of using a flap without catheterization of the small saphenous vein, necrosis of the “sural” flap was observed in 5 (22%) cases. During catheterization of the small saphenous vein, the number of flap necrosis was 2 (15%) cases. Catheterization of the small saphenous vein of the “sural” flap allows to reduce the frequency of complications related to blood supply disorders by 7%.