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Diabetic foot resurfacing using microvascular tissue transfer from lateral thoracic region
Lan Sook Chang1, Dong Woo Jang2, Youn Hwan Kim1
1Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
Diabetes/Metabolism Research and Reviews
|November 22, 2022
Summary
Free flaps from the lateral thoracic region demonstrate high success rates for diabetic foot limb salvage. This approach significantly improves outcomes, reducing the need for amputation and its associated mortality risks.
Area of Science:
- Plastic Surgery
- Diabetology
- Vascular Surgery
Background:
- Diabetic foot ulcers are a severe complication of diabetes mellitus, frequently necessitating amputation.
- High mortality rates post-amputation underscore the critical need for effective limb salvage strategies.
Purpose of the Study:
- To evaluate the 10-year experience with free flaps from the lateral thoracic region for diabetic foot limb salvage.
- To analyze the efficacy and outcomes of this reconstructive technique.
Main Methods:
- Retrospective analysis of 83 diabetic foot patients who underwent free flap surgery from the lateral thoracic region between 2009 and 2018.
- Surgical techniques included thoracodorsal artery perforator flaps and chimaeric flaps; some patients also had percutaneous transluminal angioplasty.
Main Results:
- A high flap survival rate of 98.8% and a limb salvage rate of 96.4% were achieved.
- The mean follow-up period was 6.5 years, with a recurrence rate of foot ulcers in 14 patients.
Conclusions:
- Free flaps from the lateral thoracic region offer superior outcomes for diabetic foot limb salvage compared to existing literature.
- The long vascular pedicle and chimaeric flap techniques show promise for complex or vascularly compromised diabetic foot defects.
