Loss of substances over the heel and the lateral calcaneum constitutes difficult problem. Also absence of peripheral pulses, antecedent coronary or peripheral vascular thromboses constitute some of the hazards of local flap survival. The use of laser doppler fluximetery and estimation of transcutaneous O2 seems a non invasive accurate method of preoperative selection and mapping as well as a good method of postoperative detection of complications and how to handle them.