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[Plastic surgical reconstruction of cutaneous loss of the heel or sole of the foot with sensitive free flaps].

In cases of total cutaneous loss of the heel or extensive cutaneous loss of the sole of the foot, the plastic surgical reconstruction by use of classical pediculated flaps requires following: - an adequate physical condition and articulations capable of enduring prolonged bed confinement in a position which is frequently uncomfortable; - a minimum of two operating procedures. It should be kept in mind that these free flaps are always insensitive and therefore subject to recurrence of wounding and trophic ulcers, etc. In order to avoid these drawbacks the authors suggest the use of a sensitive free flap, in which the neurovascular bundle is anastomosed to the existing bundle in the foot, using microsurgical techniques. Amongst the possible sensitive free flaps the authors favor the use of a sensitive latero-thoracic free flap. A detailed description of this free flap technique, its advantages and disadvantages for use in this kind of problem is described in their article. A clinical case is presented.