Ahmed Abdelrahim Shoulah
Benha University, Egypt
Aim: The study aims to present a case series of reconstruction of soft tissue defects of the heel using Radial Forearm Free Flap
(RFFF) and Anterolateral Thigh (ALT) free flaps with microsurgical techniques.
Method: The study included 25 patients with soft tissue defect of the heel treated in the Department of General Surgery, Banha University Hospital from June 2015 to September 2017. 11 patients were treated by RFFF and 14 by ALT. Postoperatively, patients received antibiotics and the antiplatelet Clopidogrel with avoidance of weight bearing and walking for 8 to 10 weeks. At the end of follow-up, sensation and foot function were assessed in addition to patient satisfaction.
Result: The median follow-up period was 17 months (range: 15-27 months). The causes of defect were trauma (n=14), neuropathic ulcer (n=8) and neoplastic (n=3). The size of the defect ranged from 5??6 cm to 14??24 cm. Four patients (16%) had calcaneal fracture. By the end of follow up period, 21 cases (84%) showed complete success, while 2 flaps (8%) failed; two in each flap type and 2 other flaps (8%) showed partial loss of the edges (ALT flaps). Failure was due to venous congestion (n=1) and ischemia (n=1). 20 patients (80%) were satisfied with the aesthetic appearance and flap sensation.
Conclusion: Reconstruction of large heel defects using the radial forearm and anterolateral thigh free flaps provides good aesthetic and functional results with 80% success rate and no major complications. Flaps failure was due to venous congestion and ischemia.
Ahmed Abdelrahim Shoulah is a Lecturer in Plastic and Reconstructive Surgery at Benha University, Faculty of Medicine.
E-mail: [email protected]