Reconstruction of soft tissue defect of the achilles tendon with islanded VY advancement flap

Abstract

Background: Stable skin cover over exposed tendo achilles is essential for proper healing of tendo achilles to regain its normal function. Exposed tendo achilles can be a result of open injuries, repair of closed tendo achilles rupture, complications occurring after repair. Various methods have been described in literature for coverage of repaired tendo achilles for example distally based skin flaps, advancement flap, free tissue transfers and islanded flaps. This article describes the usefulness of islanded VY advancement flap for stable skin cover over tendo achilles. Methods: A 34-year-old male had a injury over left TA region following trauma causing a raw area near its insertion. Preop and intra op doppler was done to locate and verify the position of the perforator.Results: The flap survived and on follow up the tendo achilles had good function with stable, supple, healthy skin overlying the tendon. Tendoachilles strength was assessed by asking the patient to stand on toes. Conclusions: Islanded VY Advancement flap cover over tendo achilles provides a stable, reliable, single stage procedure with good aesthetic appearance.