The tactic of surgical treatment and postoperative management of patients with neurotrophic ulcers of the rearfoot based on using functional flaps

Abstract

Purpose. To perfect the tactic of surgical treatment and postoperative management of patients with the rearfoot neurotrophic ulcers based on using functional flaps. Materials and Methods. The work deals with the long-term results of surgical treatment in 46 patients with the rearfoot neurotrophic ulcers using vascularized free and non-free flaps. The authors studied quality of life in the treated patients before and after surgeries. They introduced the concept of “five-year survival of flaps”. Results. A significant improvement in quality of life after surgical treatment observed in all the patients. Within the periods below five years flap ulcerations formed in seven patients and corns in the scar site – in three ones. Conclusion. The authors consider the procedure of plasty using vascularized skin flaps with axial type of blood supply both in the free and non-free form as the most optimal one to fill soft-tissue defects developed after the rearfoot neurotrophic ulcer dissection. Competent and proper management of such patients is important. The proposed complex approach reliably improves quality of life in patients with the rearfoot neurotrophic ulcer.