Sunday, October 10, 2004

Diabetic Foot Salvage Using Anterolateral Thigh Perforator Flap

Joon Pio Hong, MD, PhD and Yoon Kyu Chung, MD, PhD.

This study reviews 32 cases of diabetic foot salvaged by using anterolateral thigh perforator flap over a 43-month period. Interdepartmental approach played a crucial role in determining the patient who were feasible for microsurgery. Partial flap necrosis was seen in 2 cases and minimal complications such as delayed healing with wound dehiscence were seen in 3 cases. All flaps survived resulting in equivocal results compared to microvascular free tissue transfer in nondiabetic patients. Patients with chronic infections were controlled without recurrences. All patients achieved bipedal gait, full weight bearing and ambulation. But recurrence of ulceration was noted in one patient who was blind, unable to perform daily inspection of the foot. Anterolateral thigh perforator flap can provide a thin skin flap suitable for contouring and improved durability. It can also be combined with vastus lateralis muscle to increase bulk and blood supply against large dead spaces and chronic infections. Anterolateral thigh perforator flaps can be used successfully to salvage diabetic foot.
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