Different surgical treatment of post-burn trophic ulcers of the plantar surface in foot burns

Burns of the plantar surface of the foot with the subsequent formation of scar is often complicated by unhealing trophic ulcers. Trophic ulcers increase due to constant local irritation, reaching various depth and area, penetrating to the bone and the tendons and covering the area of several centimetres in diameter up to the whole heel area. A total of 21 patients (12 men and nine women) have been under our observation at Samarkand Inter-Regional Burn Center, Uzbekistan, for prolonged trophic ulcers of soft tissues of the plantar surface of the foot. Ulcers sizes were from 1.0-2.5 to 3-5 cm in diameter. All patients had undergone earlier unsuccessful operation (3-5 times). The method of closure should be chosen according to both severity and localisation of the injury, using local uninjured tissues and soft scars to make bilobed skin-flap plasty, one-lobed skin-flat flap, tube graft and other shaped flaps and free grafts placed on the area of the excised scars. In 18 observations, a good result was achieved and no complications were noted. The grafts were viable, sensibility was preserved and no marginal necrosis was noticed. Patients can take up their work by 1.5-2.0 months after surgery.