title: The reconstruction of foot soft tissue defects by tangential debulking of the latissimus dorsi flap.
abstract: Reconstruction of foot soft tissue is challenging particularly in the presence of a large defect involving both dorsal and plantar surfaces. In large defects, use of a latissimus dorsi muscle (LDM) flap is the preferred coverage method, yet LDM flaps are bulky. Despite undergoing multiple debulking procedures, patients whose feet are repaired with LDM flaps must wear oversized custom-made shoes. We developed an approach to allow patients to wear regular shoes. In six patients, we used a debulking procedure that was based on tangential trimming of the flap to the level of thickness required for normal foot contour. All patients underwent debulking 3 months after initial LDM flap coverage. The mean duration of follow-up care was 21 months (range, 8 to 32 months). All flaps survived a secondary debulking procedure. One patient developed an ulcer at the weight-bearing area of a sole. All six patients were able to wear regular shoes without difficulty.
authors.affiliation: Department of Orthopaedics, Traumatology, and Hand Surgery, Medical Park Göstepe Hospital, İstanbul. mehmetbekirunal@yahoo.com
authors.forename: Ahmet Fatih
authors.initials: AF
authors.lastname: Parmaksizoğlu
authors.forename: Mehmet Bekir
authors.initials: MB
authors.lastname: Unal
authors.forename: Eren
authors.initials: E
authors.lastname: Cansü
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000175:diagnosis / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008866:Microsurgery / Q000379:methods; D010369:Pectoralis Muscles / Q000601:surgery / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult