title: Plantar flaps based on perforators of the plantar metatarsal/common digital arteries.
abstract: BACKGROUND
  Because of the unique characteristics of its integument, the affirmation "replacing like with like" becomes more than evident in the reconstruction of defects of the ultraspecialized plantar skin. But, the paucity of local resources, and especially in the forefoot, transforms this attempt in a very challenging problem. Many techniques, including skin grafts and various types of flaps were used in the management of defects in the forefoot. We present a new useful flap in the reconstruction of skin defects in the forefoot, based on small perforator vessels originating either from the plantar metatarsal arteries or plantar common digital arteries.
  
  
  METHODS
  Starting with June 2011, this flap was performed, as plantar transposition perforator flap, plantar propeller flap, or plantar propeller perforator plus flap, in seven patients with ulcers over the plantar forefoot. During a follow-up of 7 to 17 months (mean, 9.8 months), the local evolution regarding flap integration, pain, relapse, sensitive recovery, donor site, and footwear quality was analyzed.
  
  
  RESULTS
  We registered a 100% survival rate of the flaps, with delayed healing in only one case. The gait resumption was possible after 6 weeks in all cases.
  
  
  CONCLUSIONS
  This new flap, based on small perforator vessels from the plantar metatarsal or common digital arteries, and which provides a good, stable, and sensory recovery, seems to be a promising method in the reconstruction of plantar skin defects over the metatarsal heads.
authors.affiliation: Department of Plastic Surgery and Reconstructive Microsurgery, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
authors.forename: Georgescu Alexandru
authors.initials: GA
authors.lastname: Valentin
authors.affiliation: Department of Plastic Surgery and Reconstructive Microsurgery, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
authors.forename: Matei Ileana
authors.initials: MI
authors.lastname: Rodica
authors.affiliation: Department of Human Anatomy and Embryology, Medical School, University of Barcelona, Barcelona, Spain.
authors.forename: Llusa
authors.initials: L
authors.lastname: Manuel
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply / Q000601:surgery; D005534:Foot Diseases / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012775:Shoes; D016038:Skin Transplantation / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology