title: Combined pedicle and free-tissue transfer to improve functional restoration of the foot: the "backpack principle".
abstract: Reconstruction of weight-bearing areas of the foot remains a challenging problem for the reconstructive surgeon. The principle described involves the combination of an innervated regional pedicle flap providing sensate, durable coverage of the weight-bearing heel, and a microvascular fascia flap for thin, pliable coverage of a large surface defect, based on the same vascular bundle. This provides excellent long-term stability and minimizes the disruption of blood supply to the foot. The result after 3 years demonstrates that this concept may represent an interesting solution for these particular problems.
authors.affiliation: Department of Plastic and Hand Surgery - Burn Center - BG Trauma Center, University of Heidelberg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Germann
authors.forename: D
authors.initials: D
authors.lastname: Wieczorek
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D005500:Follow-Up Studies; D006365:Heel / Q000098:blood supply* / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D012039:Regional Blood Flow; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013524:Surgical Flaps; D016474:Weight-Bearing; D014945:Wound Healing / Q000502:physiology