soft tissue injury around ankle and foot are very difficult to treat. Traditionally in reconstruction of foot and ankle soft tissue defects pedicled flaps have been common mainstay. Evolution in free flap surgery has enabled surgeon to use distant fascial and muscle flap for coverage thereby minimizing morbidity. We present our experience with free flaps for reconstruction of soft tissue defects in the foot and ankle.
Materials and methods: Between April 2016 and March 2017, 11 consecutive patients with average age 33 years (3-60 years old), were referred to our services with soft tissue defect over ankle and foot. This case series consists of patients from either traumatic origin or infective origin. Area of the wound ranges from 80 cm square to 300 cm square (average-130cmsq). All patients were operated under epidural or general anesthesia. All required clinical, laboratory and radiological investigation done before operative procedure to check eligibility of patient for operative procedure.
Results: All the patients tolerated the procedure well. 7flaps were free antero-lateral thigh flap, 3 flaps were free lattissimus dorsi muscle flap and one was free gracillis muscle flap. There was one case of partial necrosis of flap, however the remainder of the flap survived and wound healed completely. Remaining 10 flaps were survived completely. There was one patient who developed donor site graft loss which eventually heals with another skin grafting procedure. Average discharge time of the patient was nine day.
Conclusion: Large defects with exposed bone/ implant with or without infection are best handled with a free flap. Free flaps in our experience are a versatile option for reconstruction for soft tissue defect of ankle and foot.