Reconstruction of Heel Soft Tissue Defects: An Algorithm Based on Our Experience

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Krishna Deepak; Chaturvedi Gaurav; M Khan Manal; Prakash Rao Cheruvu Ved; Laitonjam Michael; Minz Reena

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Journal Paper

Paper Information

Journal: WORLD JOURNAL OF PLASTIC SURGERY Year:2021 | Volume:10 | Issue:3 Page(s): 63-72

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Title

Reconstruction of Heel Soft Tissue Defects: An Algorithm Based on Our Experience

Author(s)

Keywords

Heel reconstruction

Extended reverse sural artery flap

Calcaneal osteomyelitis

Heel defect

Medial plantar artery flap

Abstract

BACKGROUND Sensory recovery and durability of the flap is the primary goal of heel soft tissue reconstruction. From the different options, the choice of the flap depends on the size of the defect, its location, and the availability of the donor area. METHODS In this retrospective study, 40 patients having Heel defects were included from Jan 2016 to Dec 2018 in which different flaps were used for the reconstruction. The outcome was evaluated in terms of flap survival, recovery of sensation, the durability of coverage, and functional denouement. We also analysed the outcome between neuropathic and non-neuropathic ulcers of the heel. RESULTS Out of 40 patients’,medial plantar artery islanded flap was performed in eight cases, extended reverse sural flap in 16 cases, islanded reverse sural flap in six cases, local flaps in six cases, cross-leg flap in two cases, and free Latissimus Dorsi muscle flaps with Skin Graft cover in two cases. The patients were observed for a mean follow-up time of 15 months (12-20 months). Only two flaps showed marginal necrosis as an immediate complication. The majority of the flaps were tenacious in the follow-up period except for the six flaps that developed delayed ulceration. Return of protective sensation (P=0. 006) and mean American Orthopaedic Foot and Ankle Society subjective score (P=0. 025) was significantly higher in the non-neuropathic ulcer group. CONCLUSION Locoregional flaps can cover most of the Heel defects with a satisfactory outcome. The functional outcome was lower in the reconstructed neuropathic heel ulcer group.

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APA: Copy

Krishna, Deepak, Chaturvedi, Gaurav, M Khan, Manal, Prakash Rao Cheruvu, Ved, Laitonjam, Michael, & Minz, Reena. (2021). Reconstruction of Heel Soft Tissue Defects: An Algorithm Based on Our Experience. WORLD JOURNAL OF PLASTIC SURGERY, 10(3), 63-72. SID. https://sid.ir/paper/1023090/en

Vancouver: Copy

Krishna Deepak, Chaturvedi Gaurav, M Khan Manal, Prakash Rao Cheruvu Ved, Laitonjam Michael, Minz Reena. Reconstruction of Heel Soft Tissue Defects: An Algorithm Based on Our Experience. WORLD JOURNAL OF PLASTIC SURGERY[Internet]. 2021;10(3):63-72. Available from: https://sid.ir/paper/1023090/en

IEEE: Copy

Deepak Krishna, Gaurav Chaturvedi, Manal M Khan, Ved Prakash Rao Cheruvu, Michael Laitonjam, and Reena Minz, “Reconstruction of Heel Soft Tissue Defects: An Algorithm Based on Our Experience,” WORLD JOURNAL OF PLASTIC SURGERY, vol. 10, no. 3, pp. 63–72, 2021, [Online]. Available: https://sid.ir/paper/1023090/en

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