Publication:

Propellar flap: safe, reliable option for coverage of exposed tendo achilles

Background Stable skin cover over exposed tendo achilles is absolutely essential for proper healing and recovery of tendo achilles function. Exposed tendo achilles can be a result of open injuries, repair of closed TArupture, complications after repair like suture dehiscence, skin necrosis, infection, delayed exposure and recurrent rupture. Various methods have been described for coverage of repaired tendo achilles like distally based skin flaps, advancement flap, free tissue transfers and islanded flaps. This study describes the usefulness of islanded propeller flap for stable skin cover over tendo achilles.

Methods Over a period of 4 years from March 2012 to August 2016 with total cases were 6, all male patients between 16 to 56 years of age were included in the study. Method of tendo achilles repair/reconstruction was planned, based on individual case requirement. All patients underwent islanded propeller flap for coverage of exposed tendo achilles. All cases were followed up for at least 1 year.

Results All flaps except one case survived and on follow up the function of tendo achilles was excellent with stable, supple, healthy skin overlying the tendon. Tendoachilles strength was assessed by asking the patient to stand on toes.

Conclusions Islanded propeller flap cover over tendoachilles provides a stable, reliable, single stage procedure with good aesthetic appearance.