DOI: https://doi.org/10.22263/2312-4156.2026.1.85
V.P. Bulavkin1, Y.S. Ladzik1, A.P. Glyzdou2, V.V. Zuzenko2, S.M. Yermashkevich1, A.V. Harbunou2, O.V. Novikova2
Plastic closure technique of calcaneal defect with sural flap grafting in massive sequential compression syndrome
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
Vestnik VGMU. 2026;25(1):85-92.
Abstract.
Currently, the treatment of calcaneal osteomyelitis remains a pressing issue in surgery and traumatology. There is no unified correct and optimal approach to individual cases of osteomyelitis, though many scientists and practicing physicians are searching for treatment methods of the given pathology. The complexity of treating calcaneal osteomyelitis is due to the peculiarities of the blood supply to this anatomical region as well as absence of muscles. Traditional treatment methods include active surgical debridement of the infection site and systemic antibiotic administration. Surgical debridement includes removal of the necrotic soft tissue, removal of bone sequestra, and complete possible elimination of the causative agent of the surgical infection. Subsequently, replacement of the bone tissue with autogenous and allogeneic bone grafts harvested from the iliac wing, tibial tuberosity, rib, etc., and various flaps (including muscle and fasciocutaneous flaps) is carried out, followed by plastic closure of the soft tissue wound defect. To increase the volume of the bone defect and stimulate tissue repair and regeneration, the techniques using platelet-rich areas and automyeloaspirates from the red bone marrow are applied. Various methods of plastic bone defect replacement have their advantages and disadvantages, but a perfect method has not yet been found.
Conclusions. The proposed clinical example can be used in clinical practice for plastic closure of a calcaneal defect in calcaneal osteomyelitis using sural flap grafting.
Keywords: calcaneal osteomyelitis, sural flap grafting, bone graft, massive sequential compression syndrome, fibrin-platelet clot, automyeloaspirates.
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Submitted 10.11.2025
Accepted 16.02.2026
Information about authors:
V.P. Bulavkin – Candidate of Medical Sciences, associate professor of the Chair of Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
Yulia S. Ladzik – lecturer of the Chair of Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-5563-0275, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
A.P. Glyzdou – surgeon, head of the purulent surgical department, Vitebsk Regional Clinical Hospital;
V.V. Zuzenko – surgeon of the purulent surgical department, Vitebsk Regional Clinical Hospital;
S.M. Yermashkevich – Candidate of Medical Sciences, associate professor of the Chair of Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-0866-9070
A.V. Harbunou – surgeon, Regional Centre “Infection in Surgery”, Vitebsk Regional Clinical Hospital;
O.V. Novikova – surgeon, Regional Centre “Infection in Surgery”, Vitebsk Regional Clinical Hospital.
