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Reconstruction of Achilles region defects: a single-center experience
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  • Cengiz Eser,
  • Ozgün İlke Karagöz Ceylan,
  • Eyuphan Gencel,
  • Ibrahim Tabakan,
  • Ömer Kokaçya,
  • Metin Yavuz
Cengiz Eser
Cukurova University Faculty of Medicine
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Ozgün İlke Karagöz Ceylan
Cukurova University Faculty of Medicine
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Eyuphan Gencel
Cukurova University Faculty of Medicine
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Ibrahim Tabakan
Cukurova University Faculty of Medicine
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Ömer Kokaçya
Cukurova University Faculty of Medicine
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Metin Yavuz
Cukurova University Faculty of Medicine
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Abstract

Background: Reconstruction of Achilles tendon and the overlying tissue defects is a challenging undertaking. The spectrum of available repair methods range from secondary healing to use of free flaps. Method: In this study, we retrospectively evaluated 14 patients who underwent reconstruction of Achilles region defect between 2016 and 2019 at a single center. Results: Reconstructions were performed with secondary healing (n=2), negative pressure wound therapy and skin grafting (n=2), free flaps (n=6), and local and distant flaps (n=4). Satisfactory aesthetic and functional outcomes were achieved in all patients. One patient developed partial skin graft loss. Marginal necrosis occurred in one of the local flaps. Wound dehiscence and flap retraction occurred in one of the free (superficial circumflex iliac artery perforator) flaps. One patient undergoing reconstruction with ulnar artery perforator flap developed intraoperative atrial fibrillation; the operation was terminated and reconstruction completed with skin grafting. Conclusion: Orthoplastic reconstruction should be kept in mind for Achilles tendon defects. Use of special digital imaging techniques facilitates flap surgery and helps minimize the risk of flap complications. Conventional approaches are suitable for shallow small skin lesions. Local flaps are good options for deeper skin defects owing to superior aesthetic outcomes. Superthin free flaps offer a distinct advantage in skillful hands. Use of multi-content free chimeric flaps for reconstruction of complex defects facilitates better anatomical repair. Cross leg or flow-through flaps may be considered in patients with compromised distal circulation. Selection of the most reliable approach for Achilles reconstruction is a key imperative to achieve favorable outcomes.

Peer review status:UNDER REVIEW

06 Jan 2021Submitted to International Journal of Clinical Practice
07 Jan 2021Submission Checks Completed
07 Jan 2021Assigned to Editor
05 Feb 2021Reviewer(s) Assigned
06 Feb 2021Review(s) Completed, Editorial Evaluation Pending
10 May 20211st Revision Received
11 May 2021Submission Checks Completed
11 May 2021Assigned to Editor
11 May 2021Review(s) Completed, Editorial Evaluation Pending