Recent modalities in soft tissue reconstruction of the foot

Abstract

The treatment of foot ulcers is often difficult, with a relatively high incidence of recurrence, especially in older patients with vascular or dysmetabolic diseases. Always consider the general condition of the patient in advance to plan the most correct treatment of the local defect. The prognosis is strictly dependent on the age of the patient and the etiology of the defect. From a surgical point of view, flaps usually give a better result than grafts, with a low rate of breakdowns or recurrence. However, grafts can be remarkably durable on weight bearing areas and may be the first choice in certain situations. Even if grafts are advisable in some patients, local flaps provide the most similar tissue and must be the first choice when the defect is not less than 3 cm wide. The advent of microsurgery and the use of free flaps have changed the approach for the treatment of large defects. Fasciocutaneous flaps for pure soft tissue loss are versatile and usually offer a suitable paddle of tissue to reconstruct either weight bearing or non weight bearing areas. Surgical recovery is fast, and the patient can wear normal shoes early on.