Microsurgical Replantation of the Posterior Heel Skin and Subcutaneous Tissue.

Abstract

A 45-year-old male presented with amputation of posterior heel soft tissue after an accident involving broken glass panes. The defect measured 4 × 6.5 cm, and the composite amputated tissue consisted of skin and subcutaneous layers. Intraoperative exploration of the amputated tissue revealed 2 perforator arteries (diameter ≤0.4 mm) in the central portion of the subcutaneous tissue and 4 superficial veins (diameter ≈0.6 mm) in the wound margin. These vessels were anastomosed end-to-end to the corresponding vessels from the wound bed using 11-0 nylon sutures. The replanted tissue survived completely. The patient retained excellent aesthetic and functional outcomes at the 13-month follow-up visit. The present case serves to demonstrate the feasibility of microsurgical replantation for the posterior heel. Although such isolated amputations are far less common than digital amputations, our experience suggests that microsurgical replantation is indicated beyond the current spectrum of clinical repertoire.