Soft Tissue Rconstruction of the Foot with Island Flap or Free Flap

The foot has unique anatomic and functional characteristics, it endures constant weight loading or alternation stimulus of shoes while standing or walking. So the foot is the challening area for reconstructive.

I have reconstructed 23 cases of foor defects with various island or free flaps from March 1990 to Feb. 1995. The patients exhibited variable causes and sizes of foot defects, 15 cases of acute trauma, 3 cases of skin cancer, 2 cases of scar of scar contacture, 2 cases of pressure sore and a case of diabetic ulcer. Free flaps were chosen in 10 cases, such as lateral arm flap, scapular flap, latissimus dorsi muscle flap, forearm flap and superficial temporal fascia flap. Island flaps were also chosen in 13 cases such as medial plantar flap, dorsalis pedis flap, reverse peroneal flap, aosterior tibial flap. All flaps were survived without necrosis. 23 cases were divided into 4 groups according to foot defect area, 9 cases of heel and plantar weight-bearing area, 3 cases of Achilles tendon area, 6 cases of heel and plantar weight-bearing area alteral malleolar area and 5 cases of dorsal foot. I rfecommend that medial plantar island flap is suitable for heel reconstruction, reverse peroneal island flap for Archiles thedon area, dorsalis pedis island flap for malleolar area, superficial temporal fascia free flap for dersal foot.