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Dorsalis pedis flap donor site: acceptable or not?
M C Samson1, S F Morris, A E Tweed
1Division of Plastic Surgery, Queen Elizabeth II Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Plastic and Reconstructive Surgery
|October 17, 1998
Summary
The dorsalis pedis flap offers reliable reconstruction but carries significant long-term donor-site risks. Delayed healing, infections, and chronic pain are common complications requiring caution during its use.
Area of Science:
- Plastic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- The dorsalis pedis flap is a versatile option for foot reconstruction, valued for its vascularity and ease of harvest.
- Previous reports have not fully detailed the long-term consequences of harvesting this flap.
Purpose of the Study:
- To evaluate the long-term donor-site morbidity associated with dorsalis pedis flap harvest.
Main Methods:
- A retrospective study of 10 male patients who underwent dorsalis pedis flap harvest between 1982 and 1984.
- Data collection included questionnaires, chart reviews, physical examinations, and photographs (mean follow-up: 13 years).
Main Results:
- All patients experienced delayed donor-site healing (average 18 months).
- Common complications included soft-tissue infections (5/8), wound breakdown (7/8), scarring (4/7), and chronic pain (6/7).
- Three patients required reoperation, and most regained preoperative activity levels.
Conclusions:
- While reconstructive outcomes can be favorable, the dorsalis pedis flap is associated with significant long-term donor-site complications.
- Delayed healing, wound revision needs, and persistent symptoms warrant cautious use of this flap.