Reconstruction of posterolateral heel defect with lateral calcaneal flap: An experience at Burns at plastic surgery center Peshawar

Abstract

Coverage of soft tissue defect around ankle has always been a daunting job for a reconstructive surgeon. Numerous  flaps have been described for the Coverage of soft tissue defect around posterior heel and lateral calcaneum ranging from local arrangement of tissue to regional and distant flaps with variable results in terms of flap success and its durability to with stand pressure and shoe wear. In this context, we share our experience of lateral calcaneal artery flap for the coverage of such defects. This study was conducted at Burns and Plastic Surgery center, Hayatabad, Peshawar from July 2019 to June 2020. Ten patients with soft tissue defects, with or without visible calcaneus or Achilles tendon in posterior heel of various etiologies were treated with lateral calcaneal artery flap. This axial flap was designed as a transposition flap based on lateral calcaneal artery and donor site is covered with partial thickness skin graft. In nine patients flap survived completely however one flap has epidermal loss which heels completely with moist dressing subsequently. Two patients had partial loss of STSG at donor site which was managed conservatively with local application of topical steroidal ointment. Sensory loss was observed at lateral aspect of foot in all patients with minimal patient concerns. All patients used regular normal shoes after 6 weeks after surgery with no notable adversity.