The lateral dorsalis pedis chain-linked artery based flap for reconstruction of the defects of the foot, ankle, and posterior heel

Abstract

Objective To introduce the surgical method of lateral dorsalis pedis chain-linked artery based flap for repairing foot, ankle, and posterior heel wounds, and to evaluate its clinical outcome. Methods From June 2013 to February 2016, 11 cases with skin defects of foot, ankle, and posterior heel wounds were reviewed. The defects were repaired using the lateral dorsalis pedis chain-linked artery based flap.The wounds in 7 cases were repaired using the island flap based on the descending branch of the anterior lateral malleolar artery. The wounds in 3 cases were repaired using the island flap based on the lateral calcaneal branch of the posterior lateral malleolar artery. The reversed flap based on the forth metatarsal artery was used in one patient. The wound defects ranged from 1.5 cm×2.0 cm to 6.0 cm×13.0 cm.The area of the flap ranged from 2 cm×3 cm to 7 cm×15 cm were used to repair the wound.The donor site was skin grafted with split-thickness skin harvested from the abdomen. Results Circulations of the all 11 cases were stable, with good wound healing after 2 weeks.10 patients had clinical follow-up. The patients were followed up from 2 months to 18 months, average of 8 months.All flap grafts survived with no bloated menifestion in pedical or cat′s ear deformity.Flaps were soft. Color was consistent with normal skin.Skin graft donor sites had no obvious scars.Patients were extremely satisfied with the result of repair. Conclusions The use of the lateral dorsalis pedis chain-linked artery based flap has many advantages, such as no sacrifice of the main vessels, extended coverage area and thin flap. It is a simple and effective method to repair wounds of the foot, ankle, and posterior heel. Key words: Surgical flaps; Foot and ankle; Reconstructive surgical procedures