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Soft Tissue Reconstruction For The Foot By Microsurgery
Han Yan, M.D..
Chinese PLA General Hospital, Beijing, China.

PURPOSE:
Soft tissue repair has evolved from the simple covering of defects to some much more sophisticated achievements,including skin texture, skin thickness and sensate recovery. The reconstructive techniques and sources of donor tissue play an important role for soft tissue reconstruction of the foot.
METHODS:
We retrospectively reviewed the case-notes of all patients who had a free flap to soft tissue defects of the foot following trauma. 39 patients with 39 free flaps were identified.These comprised of 10 scapular free flaps, 19 medial plantar free flap, 3 latissimus dorsi free flap and 7 trimmed latissimus muscular free flap followed by split thickness skin grafting.
RESULTS:
All 39 patients were invited for clinical follow-up at an out-patients clinic during 5 months and 28 months postoperatively. Chronic ulceration happened in 5 out of 7 scapular free flaps for weight-bearing area. De-fat operation had been used for 2 out of 3 scapular free flaps and 3 latissimus dorsi free flap. Other 19 medial plantar free flaps and 7 trimmed latissimus muscular free flap followed by split thickness skin grafting recovered excellent function of the foot with satisfactory aesthetics and minimal limitations in range of motion. 17 of 19 medial planar flap sensation were recovered.
CONCLUSION:
Soft tissue defects in weight-bearing area repaired by medial plantar free flaps recovered excellently with good function and skin sensate recovery. The method of trimmed latissimus muscular flap with split thickness skin grafting was a better choice to repair the dorsal defects of the foot.


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