Arch Reconstr Microsurg.  2016 May;25(1):7-11. 10.15596/ARMS.2016.25.1.7.

Reconstruction of a Mangled Foot with an Anterolateral Thigh Free Flap

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Suwon, Korea. i00325@live.co.kr
  • 2Department of Orthopedic Surgery, Ajou University Hospital, Suwon, Korea.

Abstract

PURPOSE
In recent decades, amputation is still recommended for patients with extensive lower extremity wounds requiring coverage. Although the feet contribute relatively little to total body surface area, they are essential organ for ambulation, and a high mortality rate after amputation has been reported. We report on 10 challenging cases of a mangled foot which was reconstructed using an anterolateral thigh (ALT) free flap, and analyze the advantages and disadvantages of this technique.
MATERIALS AND METHODS
This retrospective study was conducted on 10 patients who underwent reconstructive surgery on a foot. Patients' charts were reviewed for age, sex, causes, defect size and site, flap size and type, flap type, and complications. Cases with a defect size of >100 cm2 were included.
RESULTS
Seven of the 10 patients were male, and overall mean age was 38.5 years (range, 22 to 61 years). Mean defect size was 179.6 cm2 (range, 104 to 330 cm2), and mean flap size was 193 cm2 (range, 120 to 408 cm2). Three cases were reconstructed with a musculocutaneous free flap and seven cases were reconstructed with a fasciocutaneous free flap. There were two occurrences of local wound complication. All ten flaps survived well, however five patients underwent a debulking procedure to reduce flap volume.
CONCLUSION
Reconstruction of a near completely degloved soft tissue defect or a wide defect containing two or more surfaces of extremity with an ALT free flap was performed. The purpose of this case study is to report on free tissue transfer using the ALT flap for salvage of the lower extremity.

Keyword

Soft tissue injuries; Foot injuries; Free flaps

MeSH Terms

Amputation
Body Surface Area
Extremities
Foot Injuries
Foot*
Free Tissue Flaps*
Humans
Lower Extremity
Male
Mortality
Retrospective Studies
Soft Tissue Injuries
Thigh*
Walking
Wounds and Injuries
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