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J Reconstr Microsurg 2013; 29(08): 501-504
DOI: 10.1055/s-0033-1348034
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neurotized Distally Based Sural Flap for Heel Reconstruction

Mauricio J. Mendieta
1   Department of Plastic and Reconstructive Surgery, Hospital Militar Dr. Alejandro Dávila Bolaños, Managua, Nicaragua
,
Carlos Roblero
2   Department of Plastic and Reconstructive Surgery, Hospital General Regional ‘‘Dr. Rafael Pascacion Gamboa,’' Chiapas, Mexico
,
Juan C. Vega
3   Department of Plastic and Reconstructive Surgery ‘‘Dr. Fernando Ortiz Monasterio’', Hospital General de Mexico, Mexico City, Federal District, Mexico
› Author Affiliations
Further Information

Publication History

06 December 2012

29 March 2013

Publication Date:
11 June 2013 (online)

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Abstract

The use of local flaps for the reconstruction of leg has lost their popularity with the more often performed flaps on the basis of perforators and microsurgical technique. Like the head and neck reconstruction, in the lower extremity there are limited units of tissue to base the flaps because of the lack of vascularity and arc of mobilization. The distally based sural flap represents an ideal flap for the reconstruction of heel, and with the inclusion of the sural nerve, we can neurotize the flap to give the stability of a weight-bearing area and provide the necessary sensibility to avoid ulcerations of the reconstructed heel. We present a case of a 32-year-old woman with a traumatic loss of the tissue covering the heel, with a diagnosis of a pseudoepithelial hyperplasia treated in previous occasions with skin grafts that led to chronic ulcerations. A distally based sural flap was planned for a definitive coverage, planning a perineural neurorrhaphy, to the intermediate dorsal cutaneous branch of the superficial peroneal nerve to give sensibility to the flap.

Keywords

sural flap - neurocutaneous flap - heel reconstruction

Note

The authors have no financial interests of disclosures. This work was presented in October 2012 in the Second World Congress of Plastic Surgeons of Lebanese Descent, Cancún, Quintana Roo, Mexico.


 

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