No abstract

Background: Soft tissue defects of tendo Achillis and heel regions are difficult to reconstruct because of less vascularity and limited mobility of the skin. Most of these defects result from trauma, infection and excision of malignancy. Well vascularized tissues with sensation are needed to cover these defects as these regions are more prone for repeated friction and weight bearing. Aim was to study the versatility and applications of various flaps in the reconstruction of soft tissue defects of tendo Achillis and heel regionsMethods: This retrospective study was conducted in the Department of Plastic and Reconstructive Surgery, Thanjavur Medical College, Tamil Nadu, India from 2015-2019. About 22 patients with soft tissue defects of tendo Achillis and heel regions were studied. The aetiology of the defect, size of the defect and the outcome of treatment with various flaps were evaluated.Results: Of the 22 patients 20 patients were males and 2 patients were females. The age group ranged from 12 years to 68 years. Most of the defects were due to road traffic accidents. The soft tissue defects were classified into small, medium and large sized defects based on the area of the defects. Reverse sural artery flap extended lateral calcaneal artery flap, posterior tibial artery perforator flap and lateral supra malleolar flap were the various flaps used to cover these defects.Conclusions: Fascio cutaneous flaps play a major role in the reconstruction of tendo Achillis exposed defects and heel defects. Long term follow-up with physiotherapy is essential to achieve excellent function of tendo Achillis.

No abstract

Background: Reconstruction of acquired partial external auricular defects is one of the most challenging procedures in plastic surgery. Acquired segmental defects of the external ear may be due to trauma, burn, previous surgery, or infection. Aim: The aim of this study is to review the surgical method, its area of application, as well as advantages and pitfalls of reconstruction of the external ear with post auricular flaps. Materials and Methods: 24 patients with acquired partial defects of external ear were taken up for the study. The defects were classified as upper, middle and lower third defects according to the area of involvement of external ear. All these patients were treated with post auricular flap of different sizes. Results: 8 patients had upper third and 16 patients had middle third defects of the external ear. These defects were due to road traffic accidents in 18 patients (75%) and the remaining were due to human bites (25%). Most of these patients were under the influence of alcohol at the time of injury. The symmetry of the reconstructed ears was satisfactory, and the cosmetic appearance was acceptable for 18 patients. Three patients had marginal necrosis of the flap and required revision procedures. One patient had infection and graft loss in the donor area. Conclusions:The post auricular flap is an ideal reconstructive option for partial acquired defects of the external ear because of its texture, matching colour, rich blood supply and proximity to the defect.

No abstract