The Dorsalis Pedis Fascial Flap

Abstract

The dorsalis pedis fasciocutaneous flap has been used successfully in soft tissue reconstruction both as a pedicled and a free flap. The long-term donor site problems associated with this dorsalis pedis flap prompted us to look at the use of the dorsalis pedis fascial flap in soft tissue reconstruction. We describe the results of our anatomic study and clinical series of the use of the dorsalis pedis fascial flap both as a free flap and a pedicled flap. An anatomic study was performed on a fresh cadaver by injecting India ink into the anterior tibial artery and the fascial and cutaneous staining pattern was documented. Soft tissue reconstruction was performed in six patients, using the dorsalis pedis fascial flap as a free flap in four patients and a pedicled flap in two. The donor site was closed primarily in all cases. The donor and recipient wounds healed well with good aesthetic and functional results. There were no major complications in our series. The dorsalis pedis fascial flap allows us to retain the essential benefits of the dorsalis pedis flap while avoiding donor site morbidity. It provides a useful source of vascularized fascia with a potentially long pedicle.

Reconstruction of fingers after electrical injury using lateral tarsal artery flap

“…Among these free flaps, the lateral arm flap is limited by its short pedicle; the scapular flap requires a change of position during the operation, hindering a two-team approach; the anterolateral thigh flap has become the standard flap for soft-tissue defects, but it is bulky when it is applied in the hands, and the toe web flap has the similar texture to hand, but its application is limited by its size 21,22. Dorsalis pedis or medial plantar free flaps would sacrifice a major vessel 23,24…”

Simultaneous reconstruction of the oral commissure, lip and buccal mucosa with microvascular transfer of combined first–second toe web and dorsalis pedis flap

“…In 1978, Strauch B and Tsur H (5) were the first who reported the use of the first web space free flap transferred from the foot transferred to the hand. Nowadays both flaps are used as a free or pedicled fasciocutaneous flap for soft tissue reconstruction of lower-extremity, head, neck, and hand defects (6, 7). Sakai et al (8) introduced the concept of total lower lip and chin reconstruction using a free radial forearm flap, which is considered as a workhorse flap for lip reconstruction due to its pliability and color match.…”

Covering the below‐knee amputation stump with the pedicled dorsalis pedis flap from the ipsilateral foot: A case report

“…The dorsalis pedis fasciocutaneous flap is also useful for tissue transfer because of reliability and the long and thick vascular pedicle 7, 15, 16. Several authors also reported the usefulness of this flap even for the weight bearing areas of the heel 16, 17. When the flap is elevated as a pedicled flap, there is no need to perform the complicated procedure of microvascular anastomosis.…”

“…And this flap has the protective sensation of the grafted stump that is derived from superficial peroneal nerve. The most common problem of this flap is well‐known to be the donor site morbidity of poor skin graft adaptation and delayed healing 16, 17. In cases of amputated feet, the elevation of the dorsalis pedis flap is easy and safe because the flap contains enough soft tissue including deep fasciotendinous tissue.…”