Eun Seokchan, Woo Soo Jin
Seoul National University Bundang Hospital.
Department of Plastic and Reconstructive Surgery of Seoul National University Bundang Hospital, Republic of Korea.
Acta Biomed. 2022 May 11;93(2):e2022048. doi: 10.23750/abm.v93i2.11353.
The goals of heel reconstruction are functional and aesthetic. Primarily due to the particular function of the heel in supporting the entire weight of the body while standing, these goals can be achieved by providing the heel with a durable and weight-bearing surface with adequate contour. Various methods such as skin graft, fasciocutaneous, and musculocutaneous local flaps have been reported for reconstructing this area. This retrospective study introduces different kinds of free flaps for heel reconstruction.
Between July 2010 and September 2016, 13 patients underwent soft tissue reconstruction of the heel with anterolateral thigh flap, lateral arm flap, superficial circumflex iliac artery perforator flap, and temporalis muscle flap. Immediate and delayed postoperative results of the surgery were evaluated with satisfaction assessed subjectively among the patients.
There were 8 cases of anterolateral thigh flap (61.5%), 2 cases of lateral arm flap (15.3%), 2 cases of superficial circumflex iliac artery perforator flap (15.3%), and 1 case of temporalis muscle flap (7.6%). The mean duration of surgery was 261.69 (range, 114-442) minutes and the average length of absolute immobilization was 8.38 (range, 6-11) days. All flaps survived with 3 cases of minor revision due to partial necrosis, wound dehiscence, and bulky flap. There were no morbidities among donors. Satisfactory aesthetic and functional results were observed among all the patients.
This article suggests that various free flaps can be considered as reliable options in heel reconstruction, resulting in acceptable functional and aesthetic outcomes.
足跟重建的目标是恢复功能与美观。主要由于足跟在站立时支撑身体全部重量的特殊功能，通过为足跟提供具有适当轮廓的耐用负重表面可实现这些目标。已报道了多种用于重建该区域的方法，如植皮、筋膜皮瓣和肌皮局部皮瓣。本回顾性研究介绍了用于足跟重建的不同类型游离皮瓣。
2010年7月至2016年9月期间，13例患者接受了采用股前外侧皮瓣、上臂外侧皮瓣、旋髂浅动脉穿支皮瓣和颞肌瓣进行的足跟软组织重建。通过患者主观评估满意度来评价手术的即刻和延迟术后结果。
股前外侧皮瓣8例（61.5%），上臂外侧皮瓣2例（15.3%），旋髂浅动脉穿支皮瓣2例（15.3%），颞肌瓣1例（7.6%）。平均手术时长为261.69（范围114 - 442）分钟，绝对固定的平均时长为8.38（范围6 - 11）天。所有皮瓣均存活，3例因部分坏死、伤口裂开和皮瓣臃肿进行了小的修复。供区无并发症。所有患者均观察到满意的美观和功能结果。
本文表明，多种游离皮瓣可被视为足跟重建的可靠选择，能带来可接受的功能和美观效果。
