Reconstruction of the Heel, Middle Foot Sole, and Plantar Forefoot with the Medial Plantar Artery Perforator Flap: Clinical Experience with 28 Cases.
- Scaglioni MF Zurich, Switzerland From the Department of Plastic and Hand Surgery, University Hospital Zurich.
- Rittirsch D
- Giovanoli P
- 2017-09-23
Published in:
- Plastic and reconstructive surgery. - 2018
Adult
Cohort Studies
Female
Foot Diseases
Foot Injuries
Forefoot, Human
Graft Rejection
Graft Survival
Heel
Humans
Male
Melanoma
Middle Aged
Perforator Flap
Plantar Plate
Prognosis
Reconstructive Surgical Procedures
Retrospective Studies
Risk Assessment
Skin Neoplasms
Switzerland
Tibial Arteries
Weight-Bearing
Wound Healing
Young Adult
English
BACKGROUND
Defects in the weight-bearing region of the foot sole can represent a substantial restriction in quality of life and pose a challenge for reconstructive plastic surgery. The purpose of this article is to report the authors' experience with the use of the medial plantar artery perforator flap for reconstruction of defects of the foot sole in three different regions: heel, middle foot sole, and plantar forefoot.
METHODS
From January of 2003 to May of 2016, 28 patients (13 male and 15 female patients) with an average age of 54 years (range, 12 to 84 years) underwent reconstruction with 28 medial plantar artery perforator flaps. Twenty-six flaps were harvested as pedicle perforator flaps and two as free perforator flaps. All flaps were raised from the ipsilateral instep area. The defect locations included the heel (20 cases), middle foot sole (four cases), and forefoot (four cases). The causes of reconstruction were tumors in 18 patients, decubitus in eight patients, and trauma in two patients.
RESULTS
The flap sizes varied from 2.5 × 2.5 cm to 5.5 × 9.5 cm. All of the flaps survived completely after surgery, apart from one. The donor sites were all covered with a split-thickness skin graft. Follow-up observations were conducted for 4 to 12 months, and all patients had good functional recovery with satisfactory cosmetic results.
CONCLUSION
The medial plantar artery perforator flap can be considered an optimal method of foot sole reconstruction not only for covering the weight-bearing area of the heel but also for the middle and forefoot plantar region.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Defects in the weight-bearing region of the foot sole can represent a substantial restriction in quality of life and pose a challenge for reconstructive plastic surgery. The purpose of this article is to report the authors' experience with the use of the medial plantar artery perforator flap for reconstruction of defects of the foot sole in three different regions: heel, middle foot sole, and plantar forefoot.
METHODS
From January of 2003 to May of 2016, 28 patients (13 male and 15 female patients) with an average age of 54 years (range, 12 to 84 years) underwent reconstruction with 28 medial plantar artery perforator flaps. Twenty-six flaps were harvested as pedicle perforator flaps and two as free perforator flaps. All flaps were raised from the ipsilateral instep area. The defect locations included the heel (20 cases), middle foot sole (four cases), and forefoot (four cases). The causes of reconstruction were tumors in 18 patients, decubitus in eight patients, and trauma in two patients.
RESULTS
The flap sizes varied from 2.5 × 2.5 cm to 5.5 × 9.5 cm. All of the flaps survived completely after surgery, apart from one. The donor sites were all covered with a split-thickness skin graft. Follow-up observations were conducted for 4 to 12 months, and all patients had good functional recovery with satisfactory cosmetic results.
CONCLUSION
The medial plantar artery perforator flap can be considered an optimal method of foot sole reconstruction not only for covering the weight-bearing area of the heel but also for the middle and forefoot plantar region.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1097/PRS.0000000000003975
- PMID 28938363
- Persistent URL
- https://folia.unifr.ch/global/documents/90855
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