Total Heel ReconstructionWith Sural Fasciomyocutaneous Flap: Indications And Limitations

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Author(s): Nauman A. Gill, M.R.C.S., F.C.P.S. , Abdul Hameed, F.R.C.S, C.R.C.S.

Pages: 1-9 |

Complete loss of soft tissue of the heel presents great challenge to the reconstructive surgeon because of limited options for reconstruction. Reverse sural flap can be utilized to achieve the goals of heel reconstruction but it is not considered as the first option for coverage of heel defects because it is insensate. Nevertheless, the high sural or fasciomyocutaneous variety of sural flap not only provides coverage to the heel, it can simultaneously cover theAchilles tendon as well. Soft tissue defects of heel as a result of different aetiologies were included in the study. Patient demographics, co-morbidi t ies, survival of f laps and compl icat ions were noted. Over a period of seven years (July 2003 to June 2010), heel reconstruction with sural fasciomyocutaneous flap was performed on 46 patients. There age ranged from 12 to 65 years. Out of 46 flaps, 43 survived completely, 3 flaps had partial necrosis. Long term follow up showed stable wound coverage in majority of the patients. The sural fasciomyocutaneous flap should be considered as one of the options for heel reconstruction in patients where sensate flaps are not available.