Evaluation of Loco-Regional Flaps for Heel Reconstruction

Document Type : Original Article

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Department of Plastic Surgery and Burn, Faculty of Medicine, Al-Azhar University, Egypt

Abstract

Background: Soft tissue defects reconstruction of the heel region represents a challenge for a plastic surgeon due to the limited availability of local soft tissue and the special structural and functional characteristics of this region.
The aim of the work: The current study aimed to evaluate the versatility of different loco-regional flaps for heel reconstruction.
Patients and Methods: This study included 20 patients with soft-tissue defects localized to the heel. Patients were divided into four groups according to type of flap used: medial plantar, reversed sural, V–Y advancement and lateral calcaneal flap. The main outcomes were donor site morbidity, flap sensation, stability and daily activities.
Results: The age of studied patients ranged between 21 and 56 years, 14 patients were males and 6 were females, 13 patients were right sided and 7 were left sided. Thirteen defects were traumatic, 6 neuropathic and 1 post-burn unstable scar.  In reversed sural group, excellent results in 2 patients [20%], good in 6 patients [60%] and fair in 2 patients [20%]. In medial plantar flap group, excellent results in 3 patients [60 %] and good in 2 patients [40%]. In V–Y advancement flap group, all 3 patients [100%] with excellent results. In lateral calcaneal flap group, one patient was excellent [50%] and good in another patient [50%].
Conclusion: Loco-regional flaps were very useful to reconstruct soft-tissue defects in the heel defect. The flaps from plantar aspect [medial plantar and V-Y flap] were the best option for small and medium sized defects due to its minimal donor site morbidity, similar tissue to heel and protective sensation. Reversed sural and lateral calcaneal flap were another good option if the plantar flaps unavailable.  

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