Toe Fillet Flap Wound Coverage for a Multiple-ray Amputation Wound: A Case Report

Ray amputation wounds caused by diabetic foot gangrene are often left to heal by secondary intention. They can be large and take a prolonged time to heal, exposing patients to complications and risk of recurrent infection. A 77-year-old male with diabetes and peripheral vascular disease presented to our institution with left 2nd-5th toe gangrene. He underwent a successful left lower limb angioplasty with good flow to the digital arteries. Left 2nd-5th toe ray amputation was performed, with the excess viable skin of the left second toe preserved as a digital fillet flap for wound coverage. The patient was discharged on postoperative day 1. Healing was complicated by a stitch sinus, but the wound completely healed with good epithelialization at 4 months postoperatively. This case report demonstrates the utility of the toe fillet flap in the coverage of ray amputation wounds in patients with diabetes and peripheral vascular disease.