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KMID : 0376119950220020245
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Medical Journal of the Red Cross Hospital
1995 Volume.22 No. 2 p.245 ~ p.254
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V-Y Advancement Flaps in the Reconstruction of Skin Defects of the Posterior Heel and Ankle
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서정오
박준용/김유승/정성균/진건수
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Abstract
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Reconstruction of the ankle and heel remains a challenging, often frustrating problem for surgeon and patient alike.
@ES Three factors determine the complexity of the problem:
@EN 1) ankle and heel are vital musculoskeletal structures and their dysfunction inflicts great discomfort and disability on the individual.
2) Size and depth of the defect, patency of the arterial blood supply.
3) In spite of may available procedures, it may become difficult to choose a specific operation for a given patient.
Many reports have been published on the methods of reconstructing a skin defect of the posterior heel. The methods used include the skin graft, innervated skin graft, the local skin flap, the dorsalis pedis flap, the muscle flap, the
neurovascular
free
flap, the reversed fasciocutaneous flap, and so forth.
For ideal heel coverage, the tissue used should be durable, sensitive, reliable, well-padded, and easily movable, one operative procedure with minimal donor site deformity.
The V-T advancement flap is useful for reconstruction of a relatively small defect and there have been many reports on its use in the facial region.
But, there have been few reports concerning V-Y advancement flap raised in the extremities because of the poorer blood supply to the skin in this region compared with the face and trunk.
We have experienced six cases of V-Y advancement flap including fascia in the reconstruction of skin defects of the posterior heel and ankle; three cases were trauma, and another three cases were heel ulcer, burn and infection.
All were survived without serious complication and two superficial tip necrosis was occured, but healed with conservative treatment.
The advantages of this flap were;① short operation time with one stage ②the color and texture match is excellent ③ the remaining tissue can be used effectively ④skin grafting is not required at the donor site.
In conclusion, the results indicate the reliability and usefulness of this procedure in coverage of the posterior heel and ankle regions.
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KEYWORD
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