RECONSTRUCTION OF HEEL SOFT TISSUE DEFECT USING FREE GRACILIS MUSCLE FLAP (CASE REPORT)

Kim, Sung Ho; Jeong, Jae Ho; Seul, Jeong Hyun

Abstract

Although a variety of methods were employed for the coverage of heel defects, reconstruction of large soft tissue defects of the heel is not a simple task. Recently, free muscle flaps are frequently employed for heel reconstruction. Several muscles, such as latissimus dorsi, rectus abdominis, or gracilis muscle have been used for the reconstruction of large heel defects. Since 1994, 6 cases of large heel defects were reconstructed using free gracilis flaps with split-thickness skin grafts, and the results were successful. This method is suitable for moderate to large size heel defects, except for the extensive complex defects beyond the heel territory. The major advantages are (1) relatively simple free flap (2) the volume of the muscle, after denervation atrophy, is so completely fit for the heel defect that special shoe is seldom necessary (3) donor defect is minimal, aesthetically and functionally (4) long gracilis muscle with proximal pedicle provides flexibility of shaping the heel (5) the capacity to withstand shear-force is much better than that of musculocutaneous flaps. All flaps survived completely and the results were successful. Our experiences, operative procedures and the results of maximum two rears of follow-up are presented with our descriptive method for heel defects.