Xuekang Yang1, Zhuoqun Fang1, Mengdong Liu1, Yue Zhang1, Qiaohua Chen1, Ke Tao1, Juntao Han1, Dahai Hu2. 1. Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China. 2. Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China. Electronic address: hudahaidoc@163.com.
Abstract
BACKGROUND: This study introduces a technique for the reconstruction of deep toe defects in diabetic patients using a method that combines free vascularized fascia flap with skin grafting. METHODS: In this retrospective study, conducted between March 2010 and February 2016, 15 diabetic patients with deep toe ulcer received surgeries that combined free vascularized fascia flap with skin grafting, including nine anterolateral thigh fascia lata flaps and six superficial temporal fascia flaps. Their medical records were systematically reviewed from electronic databases. The donor artery was anastomosed to the dorsalis pedis artery in an end-to-side manner, and the vein was anastomosed to the accompanying vein in an end-to-end manner. RESULTS: Thirteen fascia flaps completely survived without any rejection. Partially necrosed grafted skins, which were found in two cases, were healed after routine dressing changes. Patients achieved an esthetic outcome and acceptable functions without further revisions. Two patients suffered from ischemic necrosis of the fascia flap and eventually underwent amputation. CONCLUSIONS: The present study demonstrated that vascularized fascia flap combined with skin grafting has great advantages for correcting deep toe ulcer in diabetic patients characterized by the esthetic outcome, abundant vascularity, surgical simplicity, and good deformability.
BACKGROUND: This study introduces a technique for the reconstruction of deep toe defects in diabeticpatients using a method that combines free vascularized fascia flap with skin grafting. METHODS: In this retrospective study, conducted between March 2010 and February 2016, 15 diabeticpatients with deep toe ulcer received surgeries that combined free vascularized fascia flap with skin grafting, including nine anterolateral thigh fascia lata flaps and six superficial temporal fascia flaps. Their medical records were systematically reviewed from electronic databases. The donor artery was anastomosed to the dorsalis pedis artery in an end-to-side manner, and the vein was anastomosed to the accompanying vein in an end-to-end manner. RESULTS: Thirteen fascia flaps completely survived without any rejection. Partially necrosed grafted skins, which were found in two cases, were healed after routine dressing changes. Patients achieved an esthetic outcome and acceptable functions without further revisions. Two patients suffered from ischemic necrosis of the fascia flap and eventually underwent amputation. CONCLUSIONS: The present study demonstrated that vascularized fascia flap combined with skin grafting has great advantages for correcting deep toe ulcer in diabeticpatients characterized by the esthetic outcome, abundant vascularity, surgical simplicity, and good deformability.