Various Modalities of Flap Surgery in Heel Pad Reconstruction.

Jung, Yun Ik; Lee, Dong Won; Yoon, In Sik; Rah, Dong Kyun; Lee, Won Jai

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(4):415-420.
Published online July 1, 2011.

Various Modalities of Flap Surgery in Heel Pad Reconstruction.

Yun Ik Jung, Dong Won Lee, In Sik Yoon, Dong Kyun Rah, Won Jai Lee

Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University, College of Medicine, Seoul, Korea. pswjlee@yuhs.ac

Abstract

PURPOSE
The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. METHODS: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced.
RESULTS
There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results.
CONCLUSION
The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.

Keywords: Heel pad reconstruction; Flap surgery

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