Reverse flow sural flap (RFSF) and vacuum sealing drainage (VSD) have been used to cover soft tissue defects in the heels of children in medical emergency settings. We report a retrospective case series, including a total of 19 children with soft tissue defects in heels resulting from spokes injury. In six patients, soft tissue defects in the heel were covered with RFSF. Further, in 13 patients, the defects were covered with VSD, in seven patients defects were repaired using free skin, and in six patients defects were repaired using RFSF after VSD. All wounds in the donor and recipient areas healed by first intention, and all free skins or island flaps completely survived; the color and luster on reconstructed areas were perfect. Patients were followed up for about 3–30 months, without osteomyelitis and infection in the heel, and the functions of the heel were satisfactory. RFSF and VSD were both advantageous, and were ideal for covering heel defects in children in emergency settings.