title: Digital artery flaps for closure of soft tissue defects of the forefoot.
abstract: Reconstruction of recalcitrant soft tissue defects in the weightbearing surface of the forefoot can be achieved by using a neurovascular island flap. Island flaps, based on a pedicle from either the proper digital artery or the common digital artery, were used to provide supple and durable coverage. A retrospective analysis was performed on 12 patients who underwent a total of 15 digital artery flaps. There were 7 patients with neuropathic ulcers, 7 with a dysfunctional scar, and 1 with an ischemic ulcer after lower-extremity bypass. There was a failure rate of 13%; 2 flaps fully necrosed, necessitating a revisional digital artery flap. Minor complications were reported in 73% of cases; average time to complete healing was 71 days. All healed flaps have remained viable and durable at an average follow-up of 22.5 months from the date of surgery (range, 3 to 61 months).
authors.affiliation: Division of Podiatric Surgery, New Britain General Hospital, New Britain, CT 06062, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: Dutch
authors.forename: Michael
authors.initials: M
authors.lastname: Arnz
authors.forename: Gary Peter
authors.initials: GP
authors.lastname: Jolly
mesh_terms: D000328:Adult; D001158:Arteries / Q000601:surgery; D002921:Cicatrix / Q000601:surgery; D015331:Cohort Studies; D017719:Diabetic Foot / Q000601:surgery*; D005260:Female; D005545:Forefoot, Human / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply*; D014034:Toes / Q000098:blood supply*