Reconstruction of diabetic foot ulcers by lateral supramalleolar flap.
OBJECTIVE
To report a series of 8 diabetic patients in whom the reconstruction of large-sized defect of the foot was performed using lateral supramalleolar flap.


METHODS
Coverage of the soft tissue defect was carried out by a lateral supramalleolar flap in 8 patients who had large-sized, non-healing ulcers at the Celal Bayar University, Department of Orthopedics and Traumatology, Manisa, Turkey, between 1998-2003. The mean age was 54 years. Preoperatively Doppler flowmeter evaluation was performed, and the ischemic index was calculated in all patients.


RESULTS
The flaps survived except for one patient who had a large defect on the heel with low ischemic index. The average healing time of the ulcer region and recovery of regular walking status was 34 days. The average healing period of the donor site was 35 days. After the average follow-up period of 40 months, neither infection nor a recurrence of the ulcer was encountered. The major problem of the donor area was skin graft breakdown and its non-aesthetic appearance due to hypertrophic granulation tissue.


CONCLUSIONS
The lateral supramalleolar flap is a reliable option for the reconstruction of large-sized diabetic ulcers involving the dorsal aspect of the foot. This can also be used in conjunction with local muscle flaps, such as abductor hallucis for covering deep and large heel defects when the sural neurocutaneous flap is contraindicated.
Yercan
Huseyin S
HS
Department of Orthopedics and Traumatology, Medical Faculty, Celal Bayar University, Manisa, Turkey.
Ozalp
Tackin
T
Okcu
Guvenir
G
D000328:Adult; D000368:Aged; D017719:Diabetic Foot / Q000601:surgery; D005260:Female; D016523:Foot Ulcer / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D016896:Treatment Outcome