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

Abstract

<p class="abstract"><strong>Background:</strong> Stable skin cover over exposed tendo achilles is absolutely essential for proper healing and recovery of tendo achilles function. Exposed tendo achilles can be a result of open injuries, repair of closed TArupture, complications after repair like suture dehiscence, skin necrosis, infection, delayed exposure and recurrent rupture. Various methods have been described for coverage of repaired tendo achilles like distally based skin flaps, advancement flap, free tissue transfers and islanded flaps. This study describes the usefulness of islanded propeller flap for stable skin cover over tendo achilles.</p><p class="abstract"><strong>Methods:</strong> Over a period of 4 years from March 2012 to August 2016 with total cases were 6, all male patients between 16 to 56 years of age were included in the study. Method of tendo achilles repair/reconstruction was planned, based on individual case requirement. All patients underwent islanded propeller flap for coverage of exposed tendo achilles. All cases were followed up for at least 1 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> All flaps except one case survived and on follow up the function of tendo achilles was excellent with stable, supple, healthy skin overlying the tendon. Tendoachilles strength was assessed by asking the patient to stand on toes.</p><p><strong>Conclusions:</strong> Islanded propeller flap cover over tendoachilles provides a stable, reliable, single stage procedure with good aesthetic appearance. </p>

Versatility of Local Fasciocutaneous Island Flaps for Resurfacing Soft Tissue Defects Overlying the Achilles Tendon

“…Other studies 6 , 15 , recommended the use of distal posterior tibial artery adipofascial flap covered with STSG for reconstruction of soft tissue defects of the AT as it gives good functional outcome with minimal donor site morbidity and satisfactory cosmetic results even in female patients. Jammula et al 9 preferred to use island propeller flaps to cover the exposed AT and reported excellent functional results with stable covering in all except one patient that had flap failure due to impaired venous return. In another study, Gopalakrishnan et al 5 reconstructed soft tissue defects of the Achilles region with fasciocutaneous flaps (i.e.…”

“…Although there are many reconstructive modalities including, local fasciocutaneous or adipofascial flaps 4 , 6 , 7 , muscle flaps 8 , propeller flaps 9 , and free flaps 10 , 11 , there is still controversy regarding the optimal treatment. With the remarkable development of reconstructive microsurgery, recent studies have outlined the use of free flaps as the first choice in the management of such defects 12 .…”

A clinical study on reconstruction of small and medium sized defects of tendo Achilles and heel regions with fascio cutaneous flaps

“…4 Various flaps have been described in literature for cover over tendo Achilles like distally based skin flaps, advancement flap, free tissue transfers and islanded flaps. [5][6][7] The use of free flaps has improved the ability to cover soft tissue defects. However, the flap bulk, the need for secondary procedures, and the risk of vascular failure are considerable drawbacks.…”