Objective To report the method for repair of the heel and ankle.Method On the basis of applied anatomy,the reversed island flap based on sural neurovascular pedicle has been designed for repair of heel and ankle defects.Results The flaps have been used in 14 cases,the maximum size 9 cm×15 cm,and all flaps were survival compeletely except partial necrosis in one flap.Conclusion The blood supply of the flap is good.The length of pedicle can reach 12 cm.It is an effective method for repair of heel and ankle defects.

Objective To provide the applied anatomy of the posterior intercostal artery perforator flap and the clinical results of repairing the soft tissue defects with lateral perforator flap. Methods Six fresh adult cadavers were injected with a lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a 64-slice spiral computed tomography scanner and specialized software (Materiaise's interactive medical image control system,MIMICS).The origin,course,diameter,and distribution of the the 6-10th posterior intercostal artery perforators in the thoroax region were observed and measured.Clinically,nine cases were treated with the lateral perforator flap supplied by 7-10th posterior intercostal artery transplantation for repairing wounds in upper limbs.The flap size was 9 cm × 7 cm-16 cm × 12 cm. Results The 6-10th posterior intercostal artery perforator (outer diameter 1.70 ± 0.14 mm) were from the artery in the chest region, which pierce in deep fascia near midaxillary line. The average pedicle length from the deep fascia was (87.56 ± 6.48) mm.All of 9 cases were repaired successfully,the clinical results were satisfactory.Conclusion The posterior intercostal artery perforator flap can be used to form many kinds of axial skin flaps,it is a good option for repairing soft-tissue defect.

OBJECTIVETo study a new method to repair forefoot skin defects.

METHODSBased on anatomical studies, a reverse medialis pedis flap was designed for coverage of forefoot skin defect. The flap was based on the distal end of the medial plantar artery and had distal anastomosis with the lateral plantar artery and dorsal metatarsal artery.

RESULTSThe flap was used clinically in 6 cases. The size of the flap ranged from 4 x 3 cm to 11 x 9 cm. The pedicle of the flap was 6 to 11 cm. All flaps survived completely. The aesthetic and functional results were satisfactory after 6-24 months follow-up.

CONCLUSIONThe flap is one of the best choices for repairing of forefoot skin defects.

Adolescent ; Adult ; Female ; Foot ; anatomy & histology ; surgery ; Humans ; Male ; Surgical Flaps