Fascial Flap Coverage of Achilles Tendon Defects

Propellar flap: safe, reliable option for coverage of exposed tendo achilles

“…Various flaps have been described including the inferiorly based pedicled flap, reverse sural flap, islanded pedicled flaps, perforator flaps, propeller flaps and free flaps. [3][4][5][6][7][8][9][10][11]22 Free flaps are suitable for more extensive trauma, major avulsions and long defects, the procedure needs advanced skills, instrumentation, equipment and prolonged operating time. For moderate sized defects and majority of cases local flaps serve the purpose.…”

“…Various flaps have been described in literature for cover over TA like distally based skin flaps, advancement flap, free tissue transfers and islanded flaps. [3][4][5][6][7][8][9][10][11] The advent of islanded propeller flaps has changed the approach to reconstruction in general. Presence of abundance of perforators in the lower third of the leg arising from the posterior tibial and peroneal vessels is well documented.…”

Single-Stage Achilles Tendon Reconstruction Using a Composite Sensate Free Flap of Dorsalis Pedis and Tendon Strips of the Extensor Digitorum Longus in a Complex Wound

“…Various free flaps have been reported to achieve stable soft-tissue coverage, functional calcaneal tendon, and good contour for acceptable footwear in single-stage procedures. 2,4,[7][8][9][10][11][12][13][14][15] In the current study, a vascularized tendon, fascia, and wellvascularized muscles were used to reconstruct the tendon and in severe cases, when the distal portion of the Achilles tendon was inadequate for reconstruction, a segment of the bone was attached to anchor and to secure the setting of the tendon. Single-stage reconstruction using a free flap was reported by Wei and colleagues, 9 whereby a free groin flap was used attached with the external iliac fascia and a segment of the iliac bone, and was used to reconstruct the calcaneus.…”

“…1,3,5,6 With advances in microsurgical techniques and refinements, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area without causing further damage to the traumatized leg. 2,4,[7][8][9][10][11][12][13][14][15] We report a single-stage reconstruction of the Achilles tendon region with a composite sensate free flap of dorsalis pedis and tendon strips of the extensor digitorum longus, which may be advantageous in situations involving a large Achilles tendon defect.…”

Die Deckung von Weichteildefekten und instabilen Narben über der Achillessehne durch freie mikrochirurgische Lappenplastiken

“…Im Falle gröûerer Defekte haben sich verschiedene freie Lappenplastiken, wie der von Upton et al [2,23] verwendete M. temporalis-Faszienlappen, bewährt. Auch über die Verwendung eines fasziokutanen Radialislappens [24] sowie der M. latissimus dorsi Lappenplastik wurde berichtet [9].…”