The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel Defects
Summary:. Soft-tissue defects of the lateral heel remain a challenge for reconstructive surgeons. Although a reliable vascular supply for free flap anastomosis is available anteriorly from the anterior tibial vessels and medially from the posterior tibial vessels, the vascular anatomy of the lateral...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005412 |
| _version_ | 1797449467024113664 |
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| author | Sandra Scharfetter, MD Karl Schwaiger, MD Gottfried Wechselberger, MD-Prof |
| author_facet | Sandra Scharfetter, MD Karl Schwaiger, MD Gottfried Wechselberger, MD-Prof |
| author_sort | Sandra Scharfetter, MD |
| collection | DOAJ |
| description | Summary:. Soft-tissue defects of the lateral heel remain a challenge for reconstructive surgeons. Although a reliable vascular supply for free flap anastomosis is available anteriorly from the anterior tibial vessels and medially from the posterior tibial vessels, the vascular anatomy of the lateral side lacks suitable donor vessels for free flap anastomoses. Although the pedicle can be passed either ventrally beneath the skin or dorsally between the Achilles tendon and calcaneus, these passages are hardly applicable for lateral heel defects. We identified the space between the plantar surface of the calcaneus and the plantar aponeurosis as an innovative approach for reconstruction. Therefore, we propose the subcalcaneal fat pad as an alternative and reliable route for the passage of the flap pedicle to the posterior tibial vessels in free flap reconstruction of soft-tissue defects in the lateral calcaneal region. Consequently, the vascular pedicle can be safely anastomosed to the posterior tibial vessels. This approach provides a new option for recipient vessels in free flap reconstruction. |
| first_indexed | 2024-03-09T14:26:25Z |
| format | Article |
| id | doaj.art-0d5ae4b07d254873b65061827b4ecbc0 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-09T14:26:25Z |
| publishDate | 2023-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-0d5ae4b07d254873b65061827b4ecbc02023-11-28T07:10:12ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-11-011111e541210.1097/GOX.0000000000005412202311000-00047The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel DefectsSandra Scharfetter, MD0Karl Schwaiger, MD1Gottfried Wechselberger, MD-Prof2From the Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital of the Brothers of St. John of Gods, Paracelsus Medical University, Salzburg, Austria.From the Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital of the Brothers of St. John of Gods, Paracelsus Medical University, Salzburg, Austria.From the Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital of the Brothers of St. John of Gods, Paracelsus Medical University, Salzburg, Austria.Summary:. Soft-tissue defects of the lateral heel remain a challenge for reconstructive surgeons. Although a reliable vascular supply for free flap anastomosis is available anteriorly from the anterior tibial vessels and medially from the posterior tibial vessels, the vascular anatomy of the lateral side lacks suitable donor vessels for free flap anastomoses. Although the pedicle can be passed either ventrally beneath the skin or dorsally between the Achilles tendon and calcaneus, these passages are hardly applicable for lateral heel defects. We identified the space between the plantar surface of the calcaneus and the plantar aponeurosis as an innovative approach for reconstruction. Therefore, we propose the subcalcaneal fat pad as an alternative and reliable route for the passage of the flap pedicle to the posterior tibial vessels in free flap reconstruction of soft-tissue defects in the lateral calcaneal region. Consequently, the vascular pedicle can be safely anastomosed to the posterior tibial vessels. This approach provides a new option for recipient vessels in free flap reconstruction.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005412 |
| spellingShingle | Sandra Scharfetter, MD Karl Schwaiger, MD Gottfried Wechselberger, MD-Prof The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel Defects Plastic and Reconstructive Surgery, Global Open |
| title | The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel Defects |
| title_full | The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel Defects |
| title_fullStr | The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel Defects |
| title_full_unstemmed | The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel Defects |
| title_short | The Subcalcaneal Fat Pad: An Innovative Space for Passage of the Pedicle in Free Flap Reconstruction of Lateral Heel Defects |
| title_sort | subcalcaneal fat pad an innovative space for passage of the pedicle in free flap reconstruction of lateral heel defects |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005412 |
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