Demirseren M Erol, Gokrem Serdar, Can Zeki
Department of Plastic and Reconstructive Surgery, Ankara University School of Medicine, Ankara, Turkey.
Plast Reconstr Surg. 2004 Apr 1;113(4):1167-74. doi: 10.1097/01.prs.0000110331.78118.ad.
Reconstruction of soft-tissue defects of the calcaneal region and the heel is very demanding and necessitates, as a rule, a sensate and thin flap. The ideal characteristics of a sensate and thin layer of flap should be combined with a reliable blood supply and minimal morbidity at the donor site. The authors report an updated review of their experience with the use of island modifications of the lateral calcaneal artery skin flap-the lateral calcaneal island flap, the lateral calcaneal V-Y advancement flap, and the bilobed-shaped lateral calcaneal island advancement flap-for the reconstruction of small and medium-sized tissue defects over the exposed calcaneal tendons and calcaneal bones of 18 patients. All of the procedures were performed under spinal or epidural anesthesia. There were no problems associated with flap viability, but the authors have seen necrosis of undermined skin between the lateral malleolus and calcaneal tendon in two cases and a partial loss of skin graft in one case. In this article, the authors discuss some advantages and disadvantages of the use of a lateral calcaneal island flap and its modifications.
跟骨区域和足跟软组织缺损的重建要求很高，通常需要一个有感觉的薄皮瓣。理想的有感觉薄皮瓣应具备可靠的血供以及供区发病率最低的特点。作者报告了他们使用跟外侧动脉皮瓣的岛状改良皮瓣——跟外侧岛状皮瓣、跟外侧V-Y推进皮瓣和双叶形跟外侧岛状推进皮瓣——对18例患者暴露的跟腱和跟骨上中小型组织缺损进行重建的经验的最新回顾。所有手术均在脊髓或硬膜外麻醉下进行。皮瓣存活方面没有问题，但作者在两例中观察到外踝与跟腱之间潜行剥离的皮肤坏死，一例中出现植皮部分丢失。在本文中，作者讨论了使用跟外侧岛状皮瓣及其改良皮瓣的一些优缺点。
