Heel reconstruction with free superior lateral genicular artery perforator flap

Abstract

Reconstructing wounds on the heel can be a challenging task due to the unique characteristics of the area. The skin in this region is thin and must withstand high-stress forces, making it challenging to find appropriate options. In addition, using local and regional options may not be feasible due to previous trauma and surgery, limiting the availability and mobility of adjacent tissues. In such cases, microvascular tissue transfer procedures may be necessary. We suggest the superior lateral genicular artery perforator (SLGAP) flap as a suitable option. This flap is thin and flexible and has an adequate pedicle length and calibration. In this study, we report the successful use of the free SLGAP flap to reconstruct a 7 cm x 5 cm open wound with exposed bone on the heel that developed due to previous trauma and surgery. The SLGAP flap is based on the perforators of the superior lateral genicular artery. These perforators pierce between the lateral vastus and biceps femoris muscles and reach the skin. The flap is suitable for heel reconstruction because the skin island is thin and flexible; the pedicle vessels are calibrated and suitable for microsurgery, and the pedicle length is appropriate. There were no complications during the postoperative period, and we recommend considering the SLGAP flap to close defects in the heel.