Medial plantar artery flap

Abstract

Background: The unique ability of the thick glabrous skin of the plantar heel to withstand body weight while also providing protective sensory feedback makes soft-tissue coverage of the plantar heel a particularly challenging aspect of foot reconstruction. In this study, we present the outcomes and complications associated with medial plantar artery perforator (MPAP) flap reconstruction of plantar heel. Methods: The study was a retrospective study conducted over four years, and included 22 patients with soft-tissue injury to the plantar heel. All patients underwent MPAP flap for coverage of the defect. We studied the mode of injury, defect size, flap size, duration of the procedure, complications associated with the flap and donor site, time to full weight bearing and return of protective sensation and 2-point discrimination in comparison with opposite heel. Results: We studied 22 cases with soft-tissue defects of the heel that included post-traumatic defects (7), non-healing diabetic ulcers (6), trophic ulcers (4) and post- tumor excision defects (melanoma-3, squamous cell carcinoma-2). Mean flap dimension was 24 sq.cm. 18 flaps had complete survival, while 2 flaps had necrosis of the distal edge and 2 flaps underwent complete necrosis.