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Revascularisation versus reconstruction of degloving injuries of the heel: Case report
Author(s) -
Graf Peter,
Kalpen Axel,
Biemer Edgar
Publication year - 1995
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.1920160307
Subject(s) - degloving , medicine , heel , soft tissue , barefoot , surgery , revascularization , anatomy , physical medicine and rehabilitation , psychiatry , myocardial infarction
The anatomy of heel vascularization implies that there is a high risk of necrosis if degloved soft tissue is only sutured back to its former position. Two patients who had sustained similar degloving injuries of the heel are presented. One of them was treated by primary revascularization and the other by secondary reconstruction with a dorsalis pedis flap. The postoperative outcome was investigated to show the value of the salvage operation. Dynamic pressure distribution gait analysis was performed barefoot and in the shoe to investigate postoperative weightbearing on the reconstructed areas. In contrast to the heel reconstruction with the dorsalis pedis flap, the revascularized original heel was stable without development of soft tissue lesions. The salvaged original heel tissue enabled a physiologic pressure distribution beneath the heel and a more physiological rollover process of the foot, comparable to the contralateral foot. In degloving injuries of the heel, revascularization of the soft tissue should be considered whenever possible. © 1995 Wiley‐Liss, Inc.