Microsurgical reconstruction: The weightbearing surface of the foot

Abstract

Microsurgical reconstruction in the weightbearing surface of the foot is discussed. Thirty-eight patients treated at the Mayo Clinic are reviewed as well as a review of the current literature, leaving 122 patients for analysis. Minor complication rates in the skin grafted muscle flaps were 18.5% and major complication rates requiring further surgery were found in 12.9%. Fasciocutaneous and cutaneous flaps had a 25% incidence of minor complications and a 26% incidence of major complications requiring further surgery. No definite conclusions can be drawn as to which flap is indeed the best, but the newer, thinner fasciocutaneous flaps with innervation seem to hold promise. Future considerations are also discussed.

Free Flap Reconstruction of Foot and Ankle Defects in Pediatric Patients: Long-Term Outcome in 91 Cases

“…14 -16 Controversy remains regarding the use of skin flaps versus skin-grafted muscle flaps for weightbearing reconstruction of the foot. [17][18][19] It appears Table 4…”

Foot reconstruction in weight bearing area

“…Skin flaps reduce shearing to a minimum. Their disadvantage is their mechanical instability leading to shearing between the transplant and bed during gait as well as their large volume [24,26]. However, in reconstruction of large defects involving bone, free muscle flaps are superior, they fill deep cavities and avoid dead space [20].…”

Reconstruction of Recurrent Pressure Sores Using Free Flaps

“…Meland recommended the thinner fasciocutaneous flaps with innervation in his review of 38 microsurgical reconstructions on the weight-bearing surface of the foot. 9 Additionally, Daniel et al noted that pressure-bearing areas are covered 435 by the skin and subcutaneous tissue alone and not by the muscle in the normal anatomic state. 10 Therefore, we prefer fasciocutaneous flaps to reconstruct pressure sores.…”