J Reconstr Microsurg 2005; 21(4): 225-229
DOI: 10.1055/s-2005-871747
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Coverage of Big Toe Defects After Wrap-Around Flap Transfer with a Free Soleus Perforator Flap

Kenji Kawamura1 , Hiroshi Yajima1 , Yasunori Kobata1 , Koji Shigematsu1 , Naoki Maegawa1 , Yoshinori Takakura1
  • 1Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
Weitere Informationen

Publikationsverlauf

Accepted: January 3, 2005

Publikationsdatum:
21. Juni 2005 (online)

ABSTRACT

In thumb reconstruction, a wrap-around flap transfer from the big toe gives excellent results aesthetically and functionally; however, there may be some problems at the donor site, such as delayed wound healing and skin ulceration. In 10 patients, a free soleus perforator flap was used for immediate coverage of defects of the big toe with wrap-around flap procedures. Eight flaps survived completely, and the time required for wound healing was less than 1 month. Two flaps developed partial necrosis and required additional skin grafts. The average follow-up period was 46 months. There were no patients requiring defatting of the flaps. There were no patient complaints, such as postoperative skin erosion or ulceration. All patients were satisfied with the outcome. A free soleus perforator flap is an available method for covering defects of the big toe after wrap-around flap transfer.

REFERENCES

  • 1 Morrison W A, O'Brien B M, MacLeod A M. Thumb reconstruction with a free neurovascular wrap-around flap from the big toe.  J Hand Surg. 1980;  5A 575-583
  • 2 Yajima H, Ishida H, Tamai S. Proximal lateral leg flap transfer utilizing major nutrient vessels to the soleus muscle.  Plast Reconstr Surg. 1994;  93 1442-1448
  • 3 Wei F C, Jain V, Suominen S, Chen H C. Confusion among perforator flaps: what is a true perforator flap?.  Plast Reconstr Surg. 2001;  107 874-876
  • 4 Geddes C R, Morris S F, Neligan P C. Perforator flaps: evolution, classification, and application.  Ann Plast Surg. 2003;  50 90-99
  • 5 Morrison W A, O'Brien B M, McLeod A M. Experience with thumb reconstruction.  J Hand Surg. 1984;  9B 223-233
  • 6 Morrison W A. Thumb and fingertip reconstruction by composite microvascular tissue from the toes.  Hand Clin. 1992;  8 537-550
  • 7 Hashimoto F, Nomura S, Yamauchi S, Shimamura K, Yoshimura M. Free peroneal flap coverage of the great toe defect resulting from a wrap-around flap transfer.  Microsurgery. 1986;  7 199-202
  • 8 Inoue G, Maeda N, Suzuki K. Closure of big toe defects after wrap-around flap transfer using the arterialized venous flap.  J Reconstr Microsurg. 1991;  7 1-8
  • 9 St-Laurent J-Y, Lanzetta M. Resurfacing of the donor defect after wrap-around toe transfer with a free lateral forearm flap.  J Hand Surg. 1997;  22A 913-917
  • 10 Nunley J A, Goldner R D, Urbaniak J R. Thumb reconstruction by the wrap-around method.  Clin Orthop. 1985;  195 97-103

Kenji KawamuraM.D. 

Department of Orthopaedic Surgery, Nara Medical University

840 Shijyo-cho, Kashihara, Nara 634-8522, Japan