Abstract

GORDILLO HERNANDEZ, J. et al. Neurotization in reverse sural flap in treatment of postraumatic heel ulcer. Cir. plást. iberolatinoam. [online]. 2012, vol.38, n.4, pp.375-379. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922012000400010.

The main goal in the plantar area reconstruction is to restore the protective sensation in the zones of pressure of the heel and distal epiphysis of the first and fifth metatarsals. The reconstruction is in dependence of the defect and of 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 coverage, with constant vascularity, easy tailoring, dissection, and low morbidity of the donor site. Initially the flap was term neurofasciocutaneos due to sural nerve inclusion in the pedicle; never the less, it does not fulfill the characteristics of a sensitive flap. We present the case of a 23 year old female patient with chronic ulceration of the left heel due to trauma, treated with a reverse sural flap, not burying its pedicle, with intermittent delays, and release 22 days later, performing the coaptation of the proximal stump of the sural nerve to the medial peroneal nerve. Definitive cutaneous cover was achieved without recurrence of ulceration and appropriate protective sensibility, with a two-point discrimination in 6 months.

Keywords : Sural reverse flap; Heel; Sensitive flaps.

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