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Medial plantar perforator flaps with supermicrosurgery.
Isao Koshima1, Yuzaburo Nanba, Tetsuya Tsutsui
1Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1, Shikata, Okayama City, Okayama, Japan 700-8558. plakoshi@cc.okayama-u.ac.jp
Clinics in Plastic Surgery
|August 15, 2003
Summary
A new medial plantar perforator flap offers a versatile solution for soft-tissue defects, particularly in finger reconstruction. This innovative flap minimizes donor site morbidity and provides excellent aesthetic and functional outcomes.
Area of Science:
- Plastic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- The evolution of perforator flap techniques has led to the development of novel flap designs.
- The medial plantar perforator flap is a recent innovation, characterized by its lack of fascial component and reliance on specific vascular supply.
Observation:
- A free medial plantar perforator flap was successfully utilized for soft-tissue defect coverage in a finger.
- The flap's vascularization relies on perforators from the medial plantar vessel and a cutaneous vein, or a segment of the medial plantar vessel.
Findings:
- The medial plantar perforator flap demonstrated several advantages including minimal donor site morbidity and reduced damage to adjacent vascular systems.
- Key benefits include no need for deep dissection, ease of thinning via defatting, rapid elevation, and utilization of a large cutaneous vein for venous drainage.
- The flap offers good color and texture match for finger pulp reconstruction and results in a concealed donor scar.
Implications:
- This flap presents a valuable option for finger pulp reconstruction, offering aesthetic and functional benefits.
- Its versatility allows for potential applications as a flow-through flap or an island perforator flap for weight-bearing defects in the plantar region.