J Reconstr Microsurg 2005; 21(4): 231-234
DOI: 10.1055/s-2005-871748
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Deep Inferior Epigastric Perforator Flap for Foot Reconstruction Using an External Pedicle

Takeshi Masuoka1 , Satoshi Nomura2 , Kei Yoshimura2 , Kitaro Ohmori2
  • 1Department of Plastic Surgery, National Hospital Organization Kure Medical Center, Hiroshima, Japan
  • 2Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Police Hospital, Tokyo, Japan
Further Information

Publication History

Accepted: December 21, 2004

Publication Date:
21 June 2005 (online)

ABSTRACT

When it is necessary to apply free flaps for foot reconstruction, the choices are limited. Conventionally, split-thickness skin-grafted muscle flaps and fasciocutaneous flaps from the back or thigh have been two major options, but these methods take substantial time to wearing normal shoes. As an alternative, the authors use the deep inferior epigastric perforator (DIEP) flap with an external pedicle. After elevation and thinning of the flap, the vascular pedicle is anastomosed at a site distant from the skin defect of the foot. About 20 days after that, the pedicle is severed, and the skin island is trimmed and sutured. This method provides thin and wide coverage within a limited time, and donor-site morbidity is minimal both functionally and aesthetically.

REFERENCES

  • 1 Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle.  Br J Plast Surg. 1989;  42 645-648
  • 2 Allen R J, Treece P. Deep inferior epigastric perforator flap for breast reconstruction.  Ann Plast Surg. 1994;  32 32-48
  • 3 Blondeel N, Boeckx W D. Refinements in free flap epigastric perforator flap anastomosed to the internal mammary artery.  Br J Plast Surg. 1994;  47 495-501
  • 4 Attinger C E, Colen L B. The role of microsurgical free flaps in foot and ankle surgery.  Clin Podiatr Med Surg. 2000 ;  17 649-680
  • 5 Heller L, Levin L S. Lower extremity microsurgical reconstruction.  Plast Reconstr Surg. 2001;  108 1029-1041
  • 6 May J W, Halls M J, Simon S R. Free microvascular muscle flaps with skin graft reconstruction of extensive defects of the foot: a clinical and gait analysis study.  Plast Reconstr Surg. 1985;  75 627-639
  • 7 Weinzweig N, Davies B W. Foot and ankle reconstruction using the radial forearm flap: a review of 25 cases.  Plast Reconstr Surg. 1998;  102 1999-2005
  • 8 Kimura N, Satoh K, Hasumi T et al.. Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients.  Plast Reconstr Surg. 2001;  106 1197-1208

Takeshi MasuokaM.D. 

Department of Plastic Surgery, National Hospital Organization Kure Medical Center

3-1 Aoyama-cho, Kure

Hiroshima 737-023, Japan

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