Use of the Medial Plantar Flap in Soft Tissue Replacement Around the Heel Region
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Large ulcers around the heel region are common but difficult problems because the usual methods of resurfacing are unsatisfactory. Twelve cases of such ulcers were covered with medial plantar vascular pedicled flaps and the results had been excellent. The operative procedures were simple and the quality of skin supplied was perfect. Different sizes of medial plantar flaps may be used, based on the available branches of the posterior tibial vessels.Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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Objective:To explore and evaluate the clinical effects of the treatment of heel soft tissue defect by the island medial plantar flap.Method:18 cases of heel soft tissue defect of the of the treatment of heel soft tissue defect by island medical plantar flap.Result:All flaps survived completely.All cases were followed up for 3~12 months.The figure and feeling of the flap were good.No skin ulcer had happened.Conclusion:It is effective to use the island medial plantar flap to treat the deep heel soft tissue defect.
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Reverse flow sural flap (RFSF) and vacuum sealing drainage (VSD) have been used to cover soft tissue defects in the heels of children in medical emergency settings. We report a retrospective case series, including a total of 19 children with soft tissue defects in heels resulting from spokes injury. In six patients, soft tissue defects in the heel were covered with RFSF. Further, in 13 patients, the defects were covered with VSD, in seven patients defects were repaired using free skin, and in six patients defects were repaired using RFSF after VSD. All wounds in the donor and recipient areas healed by first intention, and all free skins or island flaps completely survived; the color and luster on reconstructed areas were perfect. Patients were followed up for about 3-30 months, without osteomyelitis and infection in the heel, and the functions of the heel were satisfactory. RFSF and VSD were both advantageous, and were ideal for covering heel defects in children in emergency settings.
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Bone, soft-tissue, and nerve deficits of the weightbearing surface of the foot are frequent sequelae from foot trauma or diabetes mellitus and present challenging treatment issues. Injury to the specialized, shock-absorbing, heel-pad tissue containing spirally arranged fat chambers is particularly difficult to manage. Appropriate footwear modifications and shoe inserts for protection of this skin are essential to the long-term management of bone and soft-tissue defects of the heel. This study evaluated the performance of a new custom total contact foot orthosis (Hindfoot Containment Orthosis, HCO) which was designed to contain the soft tissues of the heel, reduce shear forces, redistribute weightbearing load, and accommodate bone or soft-tissue deformity of the heel.Twenty-two patients treated with HCO were retrospectively reviewed. Followup averaged 26 months. The effectiveness of the orthosis was assessed by how well the integrity of the soft tissue was maintained (e.g. the number of ulcerations since dispensing the orthosis), the number of refabrications of the orthosis that were required, and whether or not revision surgery was required.Ten patients had superficial ulcerations. No patient required revision surgery. A total of 62 refabrications of the orthoses in 22 patients were required over a 2-year period. Overall results were good in 17 (77%) patients, fair in four (18%), and poor in one.The HCO is effective for preservation of soft-tissue integrity of the heel pad after bony or soft-tissue injury. Important factors in achieving success with the HCO are patient compliance and periodic monitoring for refabrication of the orthosis to accommodate skeletal growth, change in foot size or shape, and compression or wear of insert materials.
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Objective:To evaluate the therapeutic effects of modified dermal flap of lateral foot with blood supply from terminal peroneal artery for repairing of soft tissue defects of heel.Methods:Twenty-three patients with soft tissue defect of the heel or tendo calcaneus induced by trauma were treated by modified grafting of dermal flap of lateral foot.Among them,16 patients were male and 7 patients were female,ranging in age from 6 to 48 years(averagely 36.8 years).Results:All grafted flaps survived after follow-up from 5 months to 9 years, averagely 3 years and 5 months.Skin grafting surface of wound healed at I phase.The skin flap had normal colour,good function,and soft,wear-resisting characteristics without compressed ulcer.Conclusion:This repairing method posses such advantages as convenient dissection,satisfactory appearance,and good functional recovery,indicating that it is a good choice to treat soft tissue defects of heel or tendo calcaneus.
Skin grafting
Blood supply
Foot (prosody)
Peroneal Artery
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Objective To discuss the effect of medial plantar island skin flap in repairing the soft tissue defect of heel.Methods Retrospective analysed the clinical applieation of 9 cases patients of using medial plantar island skin flap in repairing the soft tissue defect of heel.Results 8 cases flaps survived unevenifully,1 cases flapsepidermal necrosis.When the 9 cases patients left hospital,wound healing,secondary suture,skin grafting.Through 1～6 months follow up,the 9 flaps survived well,and there were neither relapse of suppuration nor the formation of uleers and pressure sores.Conclusion This technique should be used to repair the soft tissue of the heel,because the flaps have excellent blood supply,it can get functional improvement.To confirm that distally island flap pedicled with vascular axis of the surral superficial,and it's a good method of may be repairing the soft tissue defect of heel.
Skin grafting
Blood supply
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Objective To explore the clinical effects of the treatment of heel soft tissue defect by the medial plantar flap. Methods 15 cases of heel soft tissue defect that had deepened to calcaneus were treated by medial plantar flaps. Results All flaps survived,and all cases were followed up for 3～12 months. The figure and feeling of all the flaps were good. Conclusions It is effective to use the medial plantar flap to treat the deep heel soft tissue defect.
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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