MANAGEMENT OF DIABETIC HEEL ULCER AND CALCANEAL CHRONIC OSTEOMYELITIS WITH LOCAL MUSCULOCUTANEOUS SURAL ARTERY FLAP

Abstract

Infected diabetic foot ulcers are a major cause of disability, morbidity, mortality and costs for the diabetic patient. Soft-tissue coverage of the infected heel ulcer is a difficult and demanding problem. Frequently, a free muscle transfer is performed. However, this procedure is time-consuming and technically demanding. The results are often not satisfactory because of a bulky contour, resulting in shoe-fitting problems. A case is presented with diabetic heel ulcer associated with calcaneal chronic osteomyelitis. He was managed successfully with local musculocutaneous sural artery flap. This flap provides satisfactory vascularization of the defect and seems to be a good alternative to free flaps for covering infected ulcers of the heel.