[Covering the foot sole and heel with pedicled and free transplants]

Thirty patients suffering from defects of the weight-bearing areas of the sole and heel were analyzed employing various methods. Sensibility was analyzed quantitatively. The level of sensibility of the flaps was found to be variable, but it had no effect on soft-tissue stability. Sensory recovery in the flaps was slow and unpredictable. Gait analysis showed that patients supplied with footwear walked relatively symmetrically even though there was a tendency to protect the flap by decreased weight-bearing. Postural control as analyzed by a sway plate was impaired only in patients with flaps having very poor sensibility. Thin skin flaps were found to be most suitable for degloving defects and muscle flaps with split-skin coverage for deep defects. The scapular flap was often too thick and was prone to develop superficial ulcerations on the weight-bearing areas.