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Microsurgical Foot Reconstruction Using Endoscopically Harvested Muscle Flaps  

Woo, Kyong-Je (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine)
Lim, So-Young (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine)
Pyon, Jai-Kyong (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine)
Bang, Sa-Ik (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine)
Oh, Kap-Sung (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine)
Mun, Goo-Hyun (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine)
Publication Information
Archives of Plastic Surgery / v.37, no.5, 2010 , pp. 571-576 More about this Journal
Abstract
Purpose: Reconstruction of soft tissue defects of the foot often requires free-flap transfer. Free muscle flap transfer and skin grafts on the muscle has been an option for these defects. Here we present our experiences of foot reconstruction using an endoscopy-assisted free muscle flap harvest. Methods: Using endoscopy-assisted free muscle flap harvests, four patients with soft tissue defects of the foot were treated with a free muscle flap and skin graft. The gracilis muscle was used for two patients and the rectus abdominis muscle for two. A single small transverse skin incision was placed on the lower abdomen for the rectus abdominis muscle. A small transverse skin incision on the proximal thigh was the only incision for harvesting the gracilis muscle flap. The small incisions were enough for the muscle flap to be pulled through. Results: The flaps survived successfully in all cases. Contours were good from both functional and aesthetic aspects. No breakdowns or ulcerations of the flap developed during long-term follow-up. Resultant scars were short and relatively hidden. Functional morbidities such as abdominal bulging were not noted. Conclusion: Endoscopy-assisted harvest of muscle flap and transfer with skin graft is a good option for soft tissue defects of the foot. Morbidities of the donor site can be minimized with endoscopic flap harvest. This method is preferable for young patients who want a small donor site scar.
Keywords
Foot reconstruction; Free flap; Endoscopic harvest;
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