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[Application of selectively thinning of free anterolateral thigh flap in repair of heel skin and soft tissue defect].

Objective
To investigate the effectiveness of selectively thinning of the free anterolateral thigh flap in repair of the heel skin and soft tissue defect.


Methods
Between April 2013 and August 2015, 8 patients with tissue defect of heel caused by different reasons were recruited. There were 6 males and 2 females with an average age of 31.2 years (range, 15-49 years). The size of wound ranged from 14 cm×10 cm to 19 cm×14 cm. All the wounds were repaired with the contralateral free anterolateral thigh flap. The partial flap which was going to repair the defects of the heel and non-weight-bearing area of planta pedis was selectively thinned. The size of flap ranged from 14 cm×10 cm to 19 cm×14 cm. The donate site was repaired by skin grafting.


Results
All flaps survived after operation, and wounds healed by first intention. The marginal necrosis of skin graft occurred in 2 cases, and healed after changing the dressing. The other skin grafts survived. All patients were followed up 8-20 months (mean, 12.3 months). All patients could walk normally. During follow-up, 2 flaps were injured and cured after symptomatic management. The appearance of flap was good in 7 cases with no influence in wearing shoes. Only 1 patient received the second-stage surgery of thinning the flap after 1 year.


Conclusion
Application of the selectively thinning of the free anterolateral thigh flap can repair the heel skin and soft tissue defects, and achieve an ideal appearance and function.