Reconstruction of a Mangled Foot with an Anterolateral Thigh Free Flap

Cook,  Kyung Hoon; Park,  Myong Chul; Park,  Dong Ha; Lee,  Il Jae; Song,  Hyung Keun; Park,  Young Uk

doi:2016.25.1.7

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Original Article

Archives of Hand and Microsurgery 2016;25(1):7-11.
Published online May 30, 2016.
DOI: https://doi.org/10.15596/ARMS.2016.25.1.7

Reconstruction of a Mangled Foot with an Anterolateral Thigh Free Flap

Kyung Hoon Cook, Myong Chul Park, Dong Ha Park, Il Jae Lee^*, Hyung Keun Song¹, and Young Uk Park¹

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

Received: 24 April 2016 • Revised: 17 May 2016 • Accepted: 19 May 2016

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.

Key Words: Soft tissue injuries, Foot injuries, Free flaps

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