Medial plantar artery island flap for heel reconstruction.
Coverage of soft tissue defects of the heel has been a challenge to reconstructive surgeons in the past. The medial plantar artery flap has facilitated heel coverage since its development in the 1980s. This was a prospective study in 2 centers assessing the complications and durability of this flap primarily in patients with sensory impairment. All patients but 1 had chronic plantar ulceration due to sensory loss, and 5 patients also had developed squamous cell carcinoma. Fifty-one flaps were carried out in 48 patients. One flap underwent necrosis, and delayed healing was seen in 4 cases. Total flap survival was 98%. Minor revision of the flap or its pedicle was required in 3 cases. With a mean follow-up of 14 months, there were recurrences of ulceration in 7 feet (14%). The relevant literature is reviewed. The medial plantar artery flap is a reliable flap for heel coverage in both our centers and others. It is durable and long lasting even in insensate.
Schwarz
Richard J
RJ
Green Pastures Hospital and Rehabilitation Centre, Pokhara, Nepal. rlschwarz@hotmail.com
Negrini
Jean-Francois
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D016523:Foot Ulcer / Q000601:surgery*; D006365:Heel / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology