Microvascular free myocutaneous flap for treatment of nonhealing ischemic ulcers of the lower extremity. A case report.

In diabetic patients, large foot ulcers that are unresponsive to conventional therapy have traditionally been treated by amputation. Arterial reconstruction alone has failed to stimulate healing of lesions with exposed bone and tendons in weight-bearing areas. We present a case in which complete healing of such an ulcer was achieved with a combination of percutaneous transluminal angioplasty and a microvascular free myocutaneous flap. Soon after discharge, the patient was able to walk well without assistance, and the muscle flap remained viable at 35 months.