Outcomes and Complications of Sole Reconstruction Using Lateral Thoracic Free Tissue Transfer

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Sole reconstruction presents challenges due to the foot's complex anatomy.
• Extensive sole defects require advanced reconstructive techniques.
• The lateral thoracic free flap is explored for its reconstructive potential.

Purpose of the Study:

• To evaluate the efficacy of the lateral thoracic free flap for comprehensive sole reconstruction.
• To assess perforator options and chimeric configurations of the lateral thoracic free flap.
• To address a gap in research regarding advanced sole defect repair.

Main Methods:

• Retrospective chart review of patients undergoing lateral thoracic free tissue transfer for sole defects.
• Data collected included patient demographics, etiologies, comorbidities, flap details, operative time, follow-up, and complications.
• Analysis of flap types used, including thoracodorsal artery perforator, latissimus dorsi, and chimeric flaps.

Main Results:

• 54 patients with sole defects (infection, trauma, tumor) underwent lateral thoracic free flap transfer.
• Thoracodorsal artery perforator flaps were most common (83.3%), followed by chimeric flaps (14.8%).
• Complications included wound dehiscence (9.3%), partial necrosis (9.3%), and pressure ulcers (22.2%), with favorable healing and minimal flap loss.

Conclusions:

• The lateral thoracic free flap is a viable and effective option for complex sole reconstruction.
• This flap offers versatility and low donor site morbidity.
• Preventing long-term pressure ulcers is an area for future research.