RÉSUMÉ
Soft tissue defect in the foot is commonly seen as it is more prone to trophic ulcers since it is the main weight bearing area of the body. Reconstruction of the weight bearing area of the foot requires the provision of a stable, supple, durable and preferably sensate skin coverage. Following Sir Gilli’s principle of replacing like with like, medial plantar artery flap provides an anatomically similar, glabrous skin for coverage on the plantar surface. In the present study, we share our clinical experience with the use of medial plantar artery flap for coverage of soft tissue defect over sole of foot. At our institution, a total of 10 patients presented with soft tissue defect of the sole, underwent medial plantar artery flap coverage. All the 10 patients were diagnosed cases of type 2 DM. patient outcome was assessed according to patients’ age distribution, duration of surgery, hospital stay, and post operative complications. Out of all the 10 patients, 5 were male and 5 were female. All the flaps healed uneventfully without major complications like partial flap necrosis. Donor site was covered with split thickness skin graft. There was suture site dehience in 2 cases which healed with secondary healing. Medial plantar artery flap has been described as an optimal reconstructive option for this type of soft tissue defect.
RÉSUMÉ
Soft tissue defect in the distal one third of leg have always posed a challenge for reconstructive surgeons. Such wounds are difficult to manage due the tenuous blood supply, limited subcutaneous cover over the tendons and bones. The aim of our study is to investigate the outcome of Dorsalis pedis artery flap for the coverage of such defects. In the present study, we share our clinical experience with the use of dorsalis pedis artery flap for the coverage of defect in the distal one third leg. This is a series of 4 cases where dorsalis pedis artery flap was used to cover lower one third defect. One case had focal squamous cell carcinoma due to long standing post burns contracture in distal one third of leg anteriorly. Other 3 cases had chronic non healing ulcer in the malleolar region. Patient outcome was assessed according to patients’ age distribution, duration of surgery, hospital stay, and post-operative complications. All 4 patients had excellent outcome with no major donor site complications, infection, and graft loss. Donor site was closed with split thickness skin graft. One patient developed a minor raw area over the dorsum of foot which healed secondarily. Although a potential risk in applying this flap is insufficient venous drainage, no problems with blood inflow or outflow were encountered in the present case series. The flaps survived, and the patient had good postoperative outcome. Hence dorsalis pedis flap can be used for the coverage of the distal foot as a good option.