Diabetic foot salvage with microsurgical free-tissue transfer

The efficacy of microsurgical free-tissue transfer for the treatment of chronic nonhealing infected diabetic foot ulcers was evaluated in a retrospective study. Between January 1992-December 1997, 10 patients underwent surgery at the American University of Beirut. Muscular free flaps were used to salvage 8 feet, and fasciocutaneous free flaps were used in 2 feet. The flap survival rate was 90%, a result that is equivalent to other series of microvascular tissue transfer in nondiabetic patients; the postoperative morbidity rate was comparable to that of nondiabetic patients. Infection control was achieved in 87.5% of patients. Seven of the 9 surviving patients had bipedal gait and were ambulatory, with full weight-bearing on their flaps at the end of the 2-year follow-up period. Microvascular free-tissue transfer can be used successfully for the salvage of infected diabetic foot ulcers.