The authors present 4 cases of foot losses of tissues of medium and small dimensions, repaired by subcutaneous adipose flaps raised from the dorsum of the foot. These relatively recent flaps came into use on identification of a subcutaneous plexus in the strict sense of the word, located between flail and dense adipose tissue, uniformly represented in all bodily regions, particularly where subcutaneous tissue is more exuberant. The surgical plan considered the base area: flap area ratio, which was kept lower than 4:1 to ensure flap survival. The largest flap raised measured 4.5 x 2.3 cm and was used to fill tissue loss caused by electric burn. In the other cases, tissue deficit was secondary to exeresis of exostosis, radiation dermititis and septic bursitis. Flap survival in all cases was 100%. During a second operation, thin covering dermoepidermal grafts were applied. In the patient affected by purulent bursitis of the 1st metatarsophalangeal articulation, the high trophic supply provided by the subcutaneous tissue permitted the local infection to be controlled in one surgical operation only. The chief advantages of this technique derive from the particular characteristics of flaps composed of subcutaneous tissue only, i.e. plasticity and versatility, associated with the very low morbidity of the donor region. Moreover, since these flaps can be raised anywhere, provided that there is sufficient subcutaneous tissue, they represent an interesting solution where conventional axial or island flaps, despite being bound to a constant vascular pedicle, are insufficient.
|Translated title of the contribution||New local subcutaneous adipose flaps in the reconstruction of foot tissue loss|
|Number of pages||8|
|Journal||Rivista Italiana di Chirurgia Plastica|
|Publication status||Published - 1998|
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