Histological and Histochemical Follow-up of the Resurfaced Heel Pad, Reconstructed by Free Flaps
10.4055/jkoa.1985.20.5.761
- Author:
Sang Soo KIM
;
Hee Kyoung PARK
;
Eung Ju MOON
- Publication Type:Original Article
- Keywords:
Heel pad defect;
Free flap
- MeSH:
Amyloid;
Blister;
Dermis;
Epidermis;
Follow-Up Studies;
Free Tissue Flaps;
Friction;
Glycosaminoglycans;
Heel;
Myocutaneous Flap;
Superficial Back Muscles;
Weight-Bearing
- From:The Journal of the Korean Orthopaedic Association
1985;20(5):761-768
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The development of the microvascular surgery revolutionalized the reconstructive surgery of the lower ext tremity. Especially, the defects of the heel and sole, the weight bearing area, were quite difficult and complicate to reconstruct by conventional methods. Many papers reported successful resurfacing the heel pad by free cutaneous or myocutaneous flaps. However, only few reports were conceming the late results of the reconstructed free flaps. The authors studied the histological and histochemical changes of the free flaps under the weight bearing stress in 10 cases. 1. The authors reconstructed 10 cases of the heel pad defects by dorsalis pedis free Aaps (5 cases) and latissimus dorsi myocutaneous flaps(5 cases). 2. Before transfer, the homy layer was very thin(about 0.16–0.2 mm) and had an arrangement of basket-weave pattem in both flaps. Until one year after transfer, this layer was wom out (0.02–0.08mm) However, after one year, this layer became thick (0.05–0.7 mm) and the arrangement was compact in both free flaps. 3. The granular and prickle cell layers were also increased in thickness after one year. 4. In the suprabasilar area, friction blisters were observed before one year, especially in latissimus dorsi myocutaneous flap. However, they slowly disappeared after one year and then the epidermis was stabilized. 5. In the dermis, the contents of the amyloid and acid mucopolysaccharides were increased up to the level of those of the normal heel pad in both flaps. 6. As a conclusion, the transferred free flaps were in distress before one year. But after one year, they began to adapt well histologically and histochemically to the weight bearing stress.
