족저부 감각피판을 이용한 조직결손 재건술

Abstract

Heel of the sole and palm of the hand are anatomically unique. Satisfactory reconstruction of these areas presents the plastic surgeon with many challenges and requires durable and sensible skin coverage, minimal donor morbidity and reliable operative procedure. We presents 15 clinical cases of sensate instep flap transfer in this paper. Ten instep island flaps and 5 instep free flaps, based on the medial plantar neurovascular bundle were transferred on hands(3 cases) and feet(12 cases) during the last 2 years. Six cases were soft tisssue defects due to wide excision of melanoma on heel. Four cases were pressure sores on heel and lateral maleolla. Four cases were avulsion injuries on palm, thumb and heel and 1 cases was contracture of first web of hand. Follow-up period ranged from 3 months to 3 years. Through the whole follow-up period, all flaps were viable and durable to withstand chronic weight bearing and were sensible enough to protect the recocstructed area from injuries and maintain functions. In conclusions, the instep flap, whatever it is island or free flap, should be considered as a valuable tool in reconstruction of sole and palm.