title: Toe resurfacing with a thin thoracodorsal artery perforator flap.
abstract: BACKGROUND
  In toe reconstruction, amputation procedures are much more common than salvage procedures. However, toe resurfacing, rather than amputation, provides superior functional and aesthetic results. In this study, we report the clinical outcomes of toe resurfacing using a thin thoracodorsal artery perforator flap.
  
  
  METHODS
  Between January 2004 and June 2013, a total of 15 patients underwent toe resurfacing using thoracodorsal artery perforator flaps. Thin flaps were harvested by discarding the deep adipose layer. Twelve cases involved a great toe defect, three, a second toe defect, three, a third toe defect, and one, a fourth toe defect. Patient ages ranged from 19 to 82 years (mean, 42.9 years). The mechanism of injury varied, including crushing injury, degloving injury, and diabetic foot infection.
  
  
  RESULTS
  The size of thoracodorsal artery perforator flap ranged from 4 × 3 to 20 × 8 cm2and the thickness of the flap ranged from 4 to 9 mm (mean, 6.5 mm). All flap survived completely without complications. The mean follow-up period was 18.8 months (range, 12-60 months). Only one patient with rheumatoid arthritis had mild gait disturbance. All patients were satisfied with the aesthetic and functional results.
  
  
  CONCLUSIONS
  Toe resurfacing with thin thoracodorsal artery perforator flaps appears to be a safer and more reliable option than amputation for preserving their function. © 2015 Wiley Periodicals, Inc. Microsurgery 37:312-318, 2017.
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Youn Hwan
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Ki Ho
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kangwon National University Hospital, Republic of Korea.
authors.forename: Kun-Yong
authors.initials: KY
authors.lastname: Sung
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Jeong Tae
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul National University Hospital, Seoul, Korea.
authors.forename: Sang Wha
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000601:surgery; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply* / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013895:Thoracic Arteries / Q000637:transplantation*; D014034:Toes / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult