International dermatosurgery: use of medial plantar based skin flaps for correction of foot defects.

The recently described instep island flap can be used to restore foot tissue deficits, however, its usefulness is limited by the length of the neurovascular pedicle and by the small surface of the flap. This flap can also be used as a free or as a cross-foot flap. We describe our experience with 10 patients. Heel defects in seven of them were corrected by the instep island flap. In the other three cases, the technique was modified, and the flap was obtained from the contralateral side, by a cross-foot flap. In these last three cases, sensibility was obtained by neurorrhaphy, with excellent results.