title: Reconstruction of lateral forefoot using reversed medial plantar flap with free anterolateral thigh flap.
abstract: Skin defects of the heel have frequently been reconstructed using the medial plantar flap; however, forefoot coverage has remained a challenge, because the alternatives for flap coverage have been very limited. We describe a case of malignant melanoma on the lateral forefoot that was radically removed and reconstructed successfully with a distally based medial plantar flap, together with a free anterolateral thigh flap. The advantages of this flap include that it does not reduce the vascular supply to the foot owing to reconstruction of the medial plantar vascular systems, reduces the risk of flap congestion, minimizes donor site morbidity, and enables the transport of structurally similar tissues to the plantar forefoot. We believe this technique is a reasonable reconstructive option for large lateral plantar forefoot defects.
authors.affiliation: Clinical Professor, Department of Plastic and Reconstructive Surgery, Nagasaki University, Nagasaki, Japan; Director, Department of Plastic and Reconstructive Surgery, Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan. Electronic address: mfujioka@nmc.hosp.go.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujioka
authors.affiliation: Staff Surgeon, Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hayashida
authors.affiliation: Staff Surgeon, Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Senju
mesh_terms: D005545:Forefoot, Human / Q000601:surgery*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D013848:Thigh
keywords: chemotherapy; free flow-through flap; interposing flap; melanoma flap; weightbearing region; wound reconstruction