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2012, Number 1

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Cir Plast 2012; 22 (1)

Sural neurotized reverse-flow flap in the treatment of post-traumatic heel sore

Ugalde VJA, Merino RC, Mendieta EM, Vega CJC

Language: Spanish
References: 20
Page: 37-42
PDF size: 414.87 Kb.


ABSTRACT

In plantar area reconstruction the objective is to restore protective feeling in the zones of pressure, the heel and distal epiphysis of the first and fifth metatarsals. This reconstruction depends on the defect and the structures to be replaced that can be treated with local, distant or microvascular free flaps. The reverse sural flap is very efficient for the heel cover, due to the fact it has constant vascularity, an easy design and dissection, and low morbidity of the donor site. Initially, the flap was called neurocutaneous, due to the inclusion of the sural nerve in the pedicle; nevertheless it does not have the characteristics of a sense flap. We present the case of a 23 year-old female patient, with chronic ulceration of the left heel, caused by trauma, treated with a reverse sural flap, externalizing its pedicle, so as to achieve intermittent delays, and three weeks after, performing the pedicle cut and the neurorraphy of the proximal stump of the sural nerve to the medial peroneal nerve. Definitive cutaneous cover was achieved, without recurrence of ulceration, and with appropriate protective sensibility, and two point tactile discrimination in six months.


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