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Current concepts of instep island flap.
Y Miyamoto1, Y Ikuta, S Shigeki
1Department of Orthopaedic Surgery, Hiroshima University School of Medicine, Japan.
Annals of Plastic Surgery
|August 1, 1987
Summary
The instep island flap offers durable heel reconstruction, but pre-existing scars can lead to complications. Sensory flaps maintain light-touch sensitivity, though donor site issues like forefoot sensory disturbance may occur.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- The instep island flap is a reconstructive option for heel defects.
- Assessing flap durability and donor site sequelae is crucial for surgical outcomes.
Purpose of the Study:
- To evaluate the long-term durability of the instep island flap for heel reconstruction.
- To analyze the sequelae associated with the flap donor site.
- To determine the functional and sensory outcomes of transferred flaps.
Main Methods:
- A retrospective review of 13 patients who underwent instep island flap reconstruction.
- Average follow-up period of 3 years and 8 months.
- Assessment of flap integrity, donor site complications, and sensory recovery (light-touch, 2-point discrimination).
Main Results:
- Flaps without preoperative scarring provided permanent, durable heel reconstruction.
- Flaps with pre-existing scars or free skin grafts developed hyperkeratosis or fissures.
- Sensory flaps preserved light-touch sensitivity and static 2-point discrimination.
- Donor site sequelae included forefoot tenderness and sensory disturbance.
Conclusions:
- The instep island flap is effective for durable heel reconstruction, particularly when scar-free.
- Careful patient selection and consideration of donor site morbidity are essential.
- Alternative treatments may be necessary for flaps with scar or those requiring free skin grafts.