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Medial plantar artery perforator flap: Experience with Soft-tissue Coverage of Heel

Plastic and Reconstructive Surgery - Global Open, ISSN: 2169-7574, Vol: 6, Issue: 12, Page: e1991
2018
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56-year-old woman with a right heel cutaneous lesion

A 56-year-old woman with no significant past medical history presented with 6-month history of a painless right heel cutaneous lesion. On exam, she had a non-tender melanotic lesion measuring approximately 2 cm x 2 cm with irregular borders and central ulceration involving the right medial heel pad (Figure 1). There was no palpable lymphadenopathy and the right lower extremity was neurovascularly

Article Description

Background: Soft-tissue coverage is a challenge to the ankle and foot reconstructive surgeon due to its unique requirement of simultaneously withstanding body weight and to provide sensory feedback. We share our experience of medial plantar artery perforator (MPAP) flap, which provides a robust sensate coverage to heel defects. Methods: Three-year retrospective study, which included soft-tissue injury to heel. All patients underwent MPAP flap for the coverage of the defect. Patients' demographic, mode of injury, defect size, flap size and survival, time to start weight bearing, return of protective sensations, and comparative 2-point discrimination with opposite heel were studied. Results: We studied 16 cases with heel soft-tissue injuries. Fifteen had motor vehicle accident, and 1 had chronic diabetic wound. Mean surface area of flap was 4×5cm. Except 1 flap, 15 flaps had complete survival and provided reliable wound coverage with comparable normal sensation as on other foot. Conclusion: We suggest that MPAP flap, when available, is a good local tissue for heel wounds coverage.

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