Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2009 Mar;1(1):1-5. doi: 10.4055/cios.2009.1.1.1. Epub 2009 Feb 6.
Soft tissue defects of the posterior heel of the foot present difficult reconstructive problems. This paper reports the authors' early experience of five patients treated with a lateral calcaneal artery adipofascial flap.
Between 2003 and 2007, five patients (3 males and 2 females) with soft-tissue defects over the posterior heel underwent a reconstruction using a lateral calcaneal artery adipofascial flap and a full-thickness skin graft. The flap sizes ranged from 3.5 x 2.5 cm to 5.5 x 4.0 cm.
All five flaps survived completely with no subsequent breakdown of the grafted skin, even after regularly wearing normal shoes. The adipofascial flap donor sites were closed primarily in all patients.
Lateral calcaneal artery adipofascial flaps should be included in the surgical armamentarium to cover difficult wounds of the posterior heel of the foot. These flaps do not require the sacrifice of a major artery to the leg or foot, they are relatively thin with minimal morbidity at the donor site, and leave a simple linear scar over the lateral aspect of the foot.
足跟后部软组织缺损的重建存在困难。本文报道了作者对 5 例应用外侧跟骨动脉脂肪筋膜皮瓣治疗的患者的早期经验。
2003 年至 2007 年间,5 例(3 男 2 女)足跟后部软组织缺损患者接受了外侧跟骨动脉脂肪筋膜皮瓣和全厚皮片移植修复。皮瓣大小为 3.5x2.5cm 至 5.5x4.0cm。
所有 5 例皮瓣均完全存活,移植皮片无后续破裂,即使在经常穿正常鞋子的情况下也是如此。所有患者的脂肪筋膜瓣供区均直接一期缝合。
外侧跟骨动脉脂肪筋膜皮瓣应作为覆盖足跟后部难愈创面的手术手段之一。这些皮瓣不需要牺牲腿部或足部的主要动脉,供区相对较薄,并发症少,在足部外侧留下一条简单的线性瘢痕。