Reconstruction of the weight-bearing heel with nonsensate reverse sural artery flaps

Ji Hun Park, In Cheul Choi, Tae Chang Hong, Jong Woo Kang, Jong Woong Park

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: The reverse sural artery flap (RSAF) is widely used to reconstruct foot and ankle defects. Although it is commonly used in a nonsensate type, there has been controversy as to whether it provides sufficient stability and durability when applied to weight-bearing heels. The aim of this study was to evaluate patient outcomes after weight-bearing heel coverage using a nonsensate RSAF. Methods: Twenty-three patients who underwent reconstruction surgery of the weight-bearing heel with RSAF from 2004 to 2018 in a tertiary hospital were retrospectively reviewed. All surgeries were performed without a sensate procedure. The patients’ experience of pressure sore on the flap area and the ability to use normal footwear were investigated. Light touch, Semmes-Weinstein test (SWT), and two-point discrimination tests were assessed, along with postoperative wound complications. Results: Heel damage etiologies included malignant tumors in 14 (61%), trauma-related in 7 (30%) and diabetic ulcers in 2 (9%) patients. Patient mean age was 58 years (range, 18–93 years) and the mean follow-up period was 57 months (range, 12–185 months). The mean size of the flap was 64.1 cm2 (range, 20–169 cm2). All flaps healed without major complications. All returned to daily living activities and 20 (86%) patients were able to use normal footwear. Of the 11 patients who had available measurement records, 8 (73%) showed a light touch sense. The mean SWT value was 4.31 (range, 3.61– 4.56). Two-point discrimination was not observed in any of the patients. Two patients had experienced superficial ulcers on the flap within a one-year postoperative period, which spontaneously healed and did not recur. No full-thickness ulcers were observed during the follow-up period. Conclusions: The results of this study suggest that patients who underwent nonsensate RSAF for the reconstruction of the heel could expect to maintain the property for stable weight-bearing without pressure sore.

Original languageEnglish
Pages (from-to)1993-1998
Number of pages6
Issue number7
Publication statusPublished - 2021 Jul


  • Nonsensate flap
  • Reverse sural artery flap
  • Weight-bearing heel

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine


Dive into the research topics of 'Reconstruction of the weight-bearing heel with nonsensate reverse sural artery flaps'. Together they form a unique fingerprint.

Cite this