[Free microsurgical flap-plasty in reconstructive therapy of diabetic foot ulcer]

The diabetic foot ulcer is a significant clinical problem often resulting in frustranous conservative treatment or early amputation. In certain cases transfer of well vascularized tissue can improve wound healing and lead to a length-spearing therapy. In this study the concept of microsurgical tissue transfer in the treatment of diabetic foot ulcers is introduced. Following a radical debridement and, if necessary a atypical length-spearing amputation the wound is covered by a free transplanted muscle flap followed by a split-thickness skin graft. In six patients treated with this procedure the extremity could be saved. The perioperative mortality was 0%, average hospitalization was 47.6 days. One flap was lost, two vascular revision were necessary. Several necrectomies and skin grafts were performed and one donor side seroma was drained. One hernia was observed after free rectus abdominus transfer. Compared to conservative treatment or amputation this concept leads to a length-spearing therapy and can increase success rates of rehabilitation and quality of life.