The dorsalis pedis fascial flap.

The dorsalis pedis fasciocutaneous flap has been used successfully in soft tissue reconstruction both as a pedicled and a free flap. The long-term donor site problems associated with this dorsalis pedis flap prompted us to look at the use of the dorsalis pedis fascial flap in soft tissue reconstruction. We describe the results of our anatomic study and clinical series of the use of the dorsalis pedis fascial flap both as a free flap and a pedicled flap. An anatomic study was performed on a fresh cadaver by injecting India ink into the anterior tibial artery and the fascial and cutaneous staining pattern was documented. Soft tissue reconstruction was performed in six patients, using the dorsalis pedis fascial flap as a free flap in four patients and a pedicled flap in two. The donor site was closed primarily in all cases. The donor and recipient wounds healed well with good aesthetic and functional results. There were no major complications in our series. The dorsalis pedis fascial flap allows us to retain the essential benefits of the dorsalis pedis flap while avoiding donor site morbidity. It provides a useful source of vascularized fascia with a potentially long pedicle.