Document Detail


Free flap reconstruction of the foot.
MedLine Citation:
PMID:  10382794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Free flap reconstruction of the foot has been widely performed in the last 20 years, but choice of a free transferred substitute for the soft tissue of the particular defect remains controversial. The authors present a series of 77 free flaps to the foot performed in 68 patients during October 1976 and September 1997. Long-term follow-up ranged from 12 months to 18 years (median, 44.4 months). Seventy-three flaps were transferred successfully (95%). The indications for a specific flap depended on the localization and extension of the foot defect. In weight-bearing areas the authors favored the use of a muscle flap covered with a split-thickness skin graft; the latissimus dorsi muscle was used primarily. This study shows a lower ulceration rate in muscle flaps covered with split-thickness skin grafts than in fasciocutaneous flaps in weight-bearing areas (27% vs. 60%). In nonweight-bearing areas, fasciocutaneous flaps were the best choice. In this series, the lateral arm flap was applied most often. The authors recommend free fascial flaps (serratus fascial flap or radial forearm fascial flap) covered by split- or full-thickness skin grafts for coverage of the malleolar region as well as coverage of exposed tendons of nonweight-bearing regions. Proper tailoring of the flap and postoperative care are very important to maintain a result without ulceration, as is avoiding having the suture line cross a weight-bearing area. Tactile sensation does not seem to be essential.
Authors:
C Rainer; A H Schwabegger; T Bauer; M Ninković; T Klestil; C Harpf; M M Ninković
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  42     ISSN:  0148-7043     ISO Abbreviation:  Ann Plast Surg     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-09-09     Completed Date:  1999-09-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  595-606; discussion 606-7     Citation Subset:  IM    
Affiliation:
Department of Plastic and Reconstructive Surgery, University of Innsbruck, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Female
Follow-Up Studies
Foot / surgery*
Foot Injuries / surgery*
Graft Survival
Humans
Male
Middle Aged
Muscles / transplantation
Postoperative Complications
Reconstructive Surgical Procedures*
Skin Transplantation
Surgical Flaps*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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