Arch Plast Surg.  2015 Sep;42(5):619-625. 10.5999/aps.2015.42.5.619.

Reconstruction of Ankle and Heel Defects with Peroneal Artery Perforator-Based Pedicled Flaps

• Ahn DK
• Lew DH
• Roh TS
• Lee WJ

• KMID: 2391879
• DOI: http://doi.org/10.5999/aps.2015.42.5.619

Abstract

BACKGROUND
The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions.
METHODS
From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review.
RESULTS
The mean age of the patients was 52.4 years. The size of the flaps ranged from 5x4 to 20x8 cm2. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities.
CONCLUSIONS
Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.

Keyword

Lower extremity; Perforator flap; Achilles tendon; Heel

MeSH Terms

Achilles Tendon
Ankle*
Arteries*
Comorbidity
Debridement
Free Tissue Flaps
Heel*
Humans
Lower Extremity
Perforator Flap
Plastics
Retrospective Studies
Surgical Flaps*
Wounds and Injuries
Plastics