Objective: To investigate the effectiveness of selectively thinning of the free anterolateral thigh flap in repair of the heel skin and soft tissue defect.
Methods: Between April 2013 and August 2015, 8 patients with tissue defect of heel caused by different reasons were recruited. There were 6 males and 2 females with an average age of 31.2 years (range, 15-49 years). The size of wound ranged from 14 cm×10 cm to 19 cm×14 cm. All the wounds were repaired with the contralateral free anterolateral thigh flap. The partial flap which was going to repair the defects of the heel and non-weight-bearing area of planta pedis was selectively thinned. The size of flap ranged from 14 cm×10 cm to 19 cm×14 cm. The donate site was repaired by skin grafting.
Results: All flaps survived after operation, and wounds healed by first intention. The marginal necrosis of skin graft occurred in 2 cases, and healed after changing the dressing. The other skin grafts survived. All patients were followed up 8-20 months (mean, 12.3 months). All patients could walk normally. During follow-up, 2 flaps were injured and cured after symptomatic management. The appearance of flap was good in 7 cases with no influence in wearing shoes. Only 1 patient received the second-stage surgery of thinning the flap after 1 year.
Conclusion: Application of the selectively thinning of the free anterolateral thigh flap can repair the heel skin and soft tissue defects, and achieve an ideal appearance and function.
目的: 探讨选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损的疗效。.
方法: 2013 年 4 月—2015 年 8 月，收治 8 例不同原因导致的足跟及足跟后区缺损患者。男 6 例，女 2 例；年龄 15～49 岁，平均 31.2 岁。创面范围为 14 cm×10 cm～19 cm×14 cm。手术切取对侧股前外侧皮瓣，将拟覆盖足底非承重区和足跟后区部分行不同程度修薄。皮瓣切取范围为 14 cm×10 cm～19 cm×14 cm。供区游离植皮修复。.
结果: 术后皮瓣均顺利成活，创面 Ⅰ 期愈合。2 例发生供区局部皮片坏死，经换药后愈合；其余植皮均顺利成活。患者均获随访，随访时间 8～20 个月，平均 12.3 个月。患者恢复正常行走，其中 2 例皮瓣发生破损，经换药后自愈。7 例皮瓣外观无臃肿，不影响穿鞋；1 例于术后 1 年行二期皮瓣修薄术。.
结论: 选择性修薄股前外侧皮瓣修复足跟及足跟后区缺损，可获得较理想足部外观和功能。.
Keywords: Anterolateral thigh flap; heel; thinning flap; wound repair.