Khan Fahad Hanif, Beg Mirza Shehab Afzal
Department of Plastic and Reconstructive Surgery, Liaquat National Hospital, Karachi, Pakistan.
Plast Reconstr Surg Glob Open. 2018 Dec 14;6(12):e1991. doi: 10.1097/GOX.0000000000001991. eCollection 2018 Dec.
Soft-tissue coverage is a challenge to the ankle and foot reconstructive surgeon due to its unique requirement of simultaneously withstanding body weight and to provide sensory feedback. We share our experience of medial plantar artery perforator (MPAP) flap, which provides a robust sensate coverage to heel defects.
Three-year retrospective study, which included soft-tissue injury to heel. All patients underwent MPAP flap for the coverage of the defect. Patients' demographic, mode of injury, defect size, flap size and survival, time to start weight bearing, return of protective sensations, and comparative 2-point discrimination with opposite heel were studied.
We studied 16 cases with heel soft-tissue injuries. Fifteen had motor vehicle accident, and 1 had chronic diabetic wound. Mean surface area of flap was 4 × 5 cm. Except 1 flap, 15 flaps had complete survival and provided reliable wound coverage with comparable normal sensation as on other foot.
We suggest that MPAP flap, when available, is a good local tissue for heel wounds coverage.
软组织覆盖对于踝关节和足部重建外科医生而言是一项挑战，因为其对同时承受体重和提供感觉反馈有独特要求。我们分享我们使用足底内侧动脉穿支（MPAP）皮瓣的经验，该皮瓣可为足跟缺损提供可靠的感觉覆盖。
为期三年的回顾性研究，包括足跟软组织损伤。所有患者均接受MPAP皮瓣覆盖缺损。研究了患者的人口统计学资料、损伤方式、缺损大小、皮瓣大小及存活情况、开始负重时间、保护性感觉恢复情况以及与对侧足跟的两点辨别觉对比。
我们研究了16例足跟软组织损伤病例。15例为机动车事故伤，1例为慢性糖尿病伤口。皮瓣平均表面积为4×5 cm。除1例皮瓣外，15例皮瓣完全存活，提供了可靠的伤口覆盖，感觉与足部其他部位相当。
我们认为，MPAP皮瓣在可行时是覆盖足跟伤口的良好局部组织。
