The instep neurovascular flap, based on the medial plantar artery and innervated by the medial plantar nerve, is in our opinion the treatment of choice for resurfacing heel skin defects. The flap is usually raised as an island flap in the non weight-bearing surface of the foot. It provides heel cover with thick skin combined with a perfectly adapted texture. Conservation of sensibility offers a protective advantage. Four patients, treated with the flap, are discussed.
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