Reconstruction Of Skin Defects Around Achilles's Tendon In Children With Rectangle Advancement Flap

Objective: To investigate the method and treatment effect of using rectangle advancement flaps in the reconstruction of skin defects around Achilles' s tendon in children.Methods: From May 2014 to June 2015,7cases of skin defects around Achilles ' s tendon in children were treated with self-designed rectangle advancement flaps in our trauma center.The area of skin defects ranged from2.7cm×3.4cm to 4.0cm×5.5cm.The integrity of the Achilles' s tendon was preserved in 6 cases,and the insertion of Achilles ' s tendon was partly disrupted in 1 case.The skin defects were reconstructed with self-designed rectangle advancement flaps.The contaminated and partly disrupted Achilles' s tendon was excised before closing the wound in 1 case.The injured ankle was immobilized in plantar flexion with K-wire and plaster splint to decrease the tension of the flap.Results: Local infection occurred in 2 cases,and healed by second intention after dressing change,the other cases healed by primary intention.All flaps survived completely.The follow up period ranged 8-12 months(average11.5months).The scares around the flap in 2 cases were remarkably,all the others showed good results in terms of color and texture of the flap.The function of the ankle was normal,and satisfactory results were obtained in all cases.Conclusion: The rectangle advancement flaps is a simple and reliable method for repairing of posterior heel skin defects in children.