A reliable method for treatment of nonhealing ulcers in the hindfoot and midfoot region in diabetic patients: Reconstruction with abductor digiti minimi muscle flap

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Tarih

2013

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Erişim Hakkı

info:eu-repo/semantics/closedAccess

Özet

The foot has a unique anatomic composition and a perfect architecture, which is necessary for mobilization. However, this complex structure is also responsible for healing problems in foot reconstruction. After 25 years of experience in diabetic foot surgery practice, we observed that some hindfoot ulcers are like an iceberg in that they have much more involvement in the plantar fat pad than the skin, and the lateral midfoot region is a common site for ulcer formation. Also the fifth tarsometatarsal joint region is a prominent anatomic structure vulnerable to repetitive trauma and ulcer formation that may easily spread to other parts of the foot. These ulcers should be reconstructed with well-vascularized tissues such as muscle flaps after debridement. Between 2003 and 2010, 17 diabetic patients with foot ulcers, involving bone and joint, were reconstructed with abductor digiti minimi muscle flap. When it is needed, the flap is covered with a small split-thickness skin graft. In all cases, complete healing was achieved. The muscle flap functioned well as a versatile and shock absorbent coverage without recurrence of the ulcer during a mean follow-up period of around 2 years. Diabetic foot ulcers should be evaluated and treated individually depending on their location and affected tissue composition. The most appropriate reconstructive option should be selected for each lesion. The abductor digiti minimi muscle flap is extremely useful for the reconstruction of small-to moderate-sized defects that have exposed bone, joint, or tendons in the hindfoot and lateral plantar midfoot. Copyright © 2012 by Lippincott Williams & Wilkins.

Açıklama

Anahtar Kelimeler

abductor digiti minim, diabetic foot ulcer, local muscle flap, reconstruction, adult, aged, article, case report, diabetic foot, evaluation, female, follow up, human, male, methodology, middle aged, plastic surgery, retrospective study, surgical flaps, treatment outcome, very elderly, wound healing, Adult, Aged, Aged, 80 and over, Diabetic Foot, Female, Follow-Up Studies, Humans, Male, Middle Aged, Reconstructive Surgical Procedures, Retrospective Studies, Surgical Flaps, Treatment Outcome, Wound Healing

Kaynak

Annals of Plastic Surgery

WoS Q Değeri

Scopus Q Değeri

Q2

Cilt

70

Sayı

1

Künye