Header

UZH-Logo

Maintenance Infos

Reconstruction of the heel, middle foot sole and plantar forefoot with the medial plantar artery perforator (MPAP) flap: clinical experience with 28 cases


Scaglioni, Mario F; Rittirsch, Daniel; Giovanoli, Pietro (2018). Reconstruction of the heel, middle foot sole and plantar forefoot with the medial plantar artery perforator (MPAP) flap: clinical experience with 28 cases. Plastic and Reconstructive Surgery, 141(1):200-208.

Abstract

INTRODUCTION: Defects in the weight-bearing region of the foot sole can represent a substantial restriction in quality of life and pose a challenge for reconstructive plastic surgery.The purpose of this article is to report our experience with the use of medial plantar artery perforator (MPAP) flap for reconstruction of defects of the foot sole in 3 different regions: heel, middle foot sole and plantar forefoot.
PATIENTS AND METHODS: From January 2003 to May 2016, 28 patients (13 males and 15 females) with an average age of 54 years (range 12 to 84 y.o.) received reconstruction with 28 MPAP flaps.26 flaps were harvested as pedicle perforator flaps and 2 as free perforator flaps. All flaps were raised from the ipsilateral instep area. The defect locations included the heel (20 cases), middle foot sole (4 cases) and forefoot (4 cases).The causes of reconstruction were tumors in 18 patients (64%), decubitus in 8 patients (29%) and trauma in 2 patients (7%).
RESULTS: The flap sizes varied from 2.5 × 2.5 cm to 5.5 × 9.5 cm. All of the flaps survived completely after surgery, apart from one. The donor sites were all covered with a split-thickness skin graft. Follow-up observations were conducted for 4 to 12 months, and all patients had good functional recovery with satisfactory cosmetic results.
CONCLUSION: The MPAP flap can be considered an optimal method of foot sole reconstruction not only for covering the weight-bearing area of the heel but also for the middle and forefoot plantar region.

Abstract

INTRODUCTION: Defects in the weight-bearing region of the foot sole can represent a substantial restriction in quality of life and pose a challenge for reconstructive plastic surgery.The purpose of this article is to report our experience with the use of medial plantar artery perforator (MPAP) flap for reconstruction of defects of the foot sole in 3 different regions: heel, middle foot sole and plantar forefoot.
PATIENTS AND METHODS: From January 2003 to May 2016, 28 patients (13 males and 15 females) with an average age of 54 years (range 12 to 84 y.o.) received reconstruction with 28 MPAP flaps.26 flaps were harvested as pedicle perforator flaps and 2 as free perforator flaps. All flaps were raised from the ipsilateral instep area. The defect locations included the heel (20 cases), middle foot sole (4 cases) and forefoot (4 cases).The causes of reconstruction were tumors in 18 patients (64%), decubitus in 8 patients (29%) and trauma in 2 patients (7%).
RESULTS: The flap sizes varied from 2.5 × 2.5 cm to 5.5 × 9.5 cm. All of the flaps survived completely after surgery, apart from one. The donor sites were all covered with a split-thickness skin graft. Follow-up observations were conducted for 4 to 12 months, and all patients had good functional recovery with satisfactory cosmetic results.
CONCLUSION: The MPAP flap can be considered an optimal method of foot sole reconstruction not only for covering the weight-bearing area of the heel but also for the middle and forefoot plantar region.

Statistics

Altmetrics

Downloads

20 downloads since deposited on 20 Dec 2017
20 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Reconstructive Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:January 2018
Deposited On:20 Dec 2017 14:42
Last Modified:28 Dec 2017 02:04
Publisher:Lippincott Williams & Wilkins
ISSN:0007-1226
Publisher DOI:https://doi.org/10.1097/PRS.0000000000003975
PubMed ID:28938363

Download

Download PDF  'Reconstruction of the heel, middle foot sole and plantar forefoot with the medial plantar artery perforator (MPAP) flap: clinical experience with 28 cases'.
Preview
Content: Accepted Version
Language: English
Filetype: PDF
Size: 2MB
View at publisher