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Bilobed flaps for nonhealing ulcer treatment
Haluk Yetkin1, Ulunay Kanatli, Akif Muhtar Oztürk
1Department of Orthopedics and Traumatology, Gazi University, Ankara, Turkey.
Foot & Ankle International
|October 4, 2003
Summary
Bilobed flaps offer a viable solution for treating difficult-to-heal plantar foot ulcers in patients with conditions like diabetes. This reconstructive technique shows promising short-term outcomes for these challenging wounds.
Area of Science:
- Plastic Surgery
- Podiatry
- Wound Healing
Background:
- Plantar ulcers present significant healing challenges due to skin rigidity and thickness, precluding primary closure.
- The bilobed flap, typically used for facial reconstruction, is explored for foot defects.
- Nonhealing plantar ulcers require innovative reconstructive strategies.
Purpose of the Study:
- To evaluate the efficacy of the bilobed flap for reconstructing round plantar ulcers.
- To assess the short-term outcomes of this technique in neuropathic foot patients.
Main Methods:
- A retrospective review of 12 neuropathic foot patients (1995-1998) with plantar ulcers treated with bilobed flaps.
- Patients underwent debridement and received orthotic insoles for at least 3 months prior to flap surgery.
- Follow-up averaged 19.5 months.
Main Results:
- The bilobed flap technique demonstrated good short-term results in treating plantar ulcers.
- One case of wound dehiscence occurred in a diabetic patient, successfully managed with a sliding flap and skin graft.
- The average ulcer size was 1.6 cm.
Conclusions:
- The bilobed skin flap is an effective reconstructive option for nonhealing plantar foot ulcers.
- This technique utilizes healthy tissues rotated from non-weightbearing areas of the sole.
- It provides a viable solution for defects where primary closure is not feasible.