Hung Chen-Ting, Lee Jiunn-Tat, Wu Meng-Si, Cheng Li-Fu
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C.
School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C.
Plast Reconstr Surg Glob Open. 2024 Mar 20;12(3):e5654. doi: 10.1097/GOX.0000000000005654. eCollection 2024 Mar.
Reconstruction of the plantar forefoot area is challenging because it performs important functions, including carrying the body weight and balancing the ambulation gait, and lacks similar skin and soft tissues to manage the adjacent region. Herein, we shared our experience of using a lateral toe pulp flap and reviewed the relevant literature on this topic. A 33-year-old man presented with a large granuloma in the left plantar forefoot area after undergoing multiple operations owing to the diagnosis of callus. After tumor excision, the wound exhibited tendon exposure and a large infected dead space in the myofascial layer. After serial debridement with negative pressure wound therapy, the wound, which measured ~3.5 × 2.5 cm, was reconstructed using a lateral toe pulp flap. The flap was transposed to obliterate the dead space; the remaining skin defect (size: ~2 × 2 cm) was resurfaced with a full-thickness skin graft, harvested from the left inguinal region, followed by primary closure of the flap donor site. The flap completely survived. The lateral toe pulp flap is an easy, effective, and reliable option for reconstruction of the defects in the plantar forefoot area.
足底前足区域的重建具有挑战性，因为它执行着重要功能，包括承载体重和平衡行走步态，并且缺乏用于处理相邻区域的类似皮肤和软组织。在此，我们分享了使用外侧趾腹皮瓣的经验，并回顾了关于该主题的相关文献。一名33岁男性因胼胝诊断接受多次手术后，左足底前足区域出现一个大的肉芽肿。肿瘤切除后，伤口出现肌腱暴露以及肌筋膜层的一个大的感染性死腔。在采用负压伤口治疗进行系列清创后，使用外侧趾腹皮瓣对约3.5×2.5厘米的伤口进行重建。将皮瓣转移以消除死腔；剩余的皮肤缺损（尺寸：约2×2厘米）用取自左腹股沟区域的全厚皮片进行覆盖，随后对皮瓣供区进行一期缝合。皮瓣完全存活。外侧趾腹皮瓣是重建足底前足区域缺损的一种简便、有效且可靠的选择。
