Original ArticleReconstruction of Soft-Tissue Defects of the Heel With Local Fasciocutaneous FlapsBenito-Ruiz, J MD, PhD; Yoon, T MD; Guisantes-Pintos, E MD; Monner, J MD; Serra-Renom, J M. MDAuthor Information From the Department of Plastic and Maxillofacial Surgery, Hospital Clinic, Barcelona, Spain. Received May 12, 2003 and accepted for publication, after revision, July 25, 2003. Reprints: Dr. J. Benito-Ruiz, Department of Plastic and Maxillofacial Surgery, Hospital Clinic, C/Villarroel 170, 08036 Barcelona, Spain. Annals of Plastic Surgery: April 2004 - Volume 52 - Issue 4 - p 380-384 doi: 10.1097/01.sap.0000105520.24063.bb Buy Metrics AbstractIn Brief Soft tissue heel defects reconstruction represents a challenge for plastic surgeons because of the poor availability of regional tissue to perform the reconstruction. We divide the heel on the anterior or weight-bearing heel and the posterior or non–weight-bearing heel. Our preferences are the fasciocutaneous instep flap for anterior heel defects and the reverse sural flap for posterior heel defects. We have performed 11 reconstructions of the heel. The complications were total necrosis of 1 instep flap in a previously irradiated patient and 1 case of partial tip necrosis in a reverse sural flap. Functional recovery has been very satisfactory for both procedures. Regional island flaps are for us the first therapeutic option because the skin is similar to the lost one and less time consuming than a free-flap reconstruction. Eleven heel reconstructions were carried out with local fasciocutaneous flaps, selecting the in-step flap for anterior defects and the reverse sural flap for posterior defects. All but one in-step flap survived, and all others are ambulatory in normal shoes. © 2004 Lippincott Williams & Wilkins, Inc.