Can Great Toe Pedicle Flaps Have An Impact For Complicated DFUs?

Start Page: 20
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Author(s): 
Karen Shum, DPM, Ronald Belczyk, DPM, Lee C. Rogers, DPM, George Andros, MD, and Larissa Lee, MD

In Summary

A successful pedicle flap requires comprehensive pre- and postoperative care, proper patient selection, a strong understanding of anatomy, and recognition and management of complications. Plastic surgery techniques like the great toe fillet flap are an effective tool for podiatric surgeons for coverage of tissue defects.

   Dr. Shum is a third-year resident with the Cedars Sinai Medical Center Podiatric Medicine and Surgery Residency Program in Los Angeles.

   Dr. Belczyk is a Fellow of the American College of Foot and Ankle Surgeons, and is board certified in both foot surgery and reconstructive rearfoot/ankle surgery by the American Board of Podiatric Surgery. He is a consultant physician at the Amputation Prevention Center at Valley Presbyterian Hospital in Van Nuys, Calif.

   Dr. Rogers is the Associate Medical Director of the Amputation Prevention Center at Valley Presbyterian Hospital in Los Angeles. He is the Chair of the Foot Care Council for the American Diabetes Association. Dr. Rogers has more than 50 publications in press or in print on diabetic foot disorders including several book chapters.

   Dr. Andros is the Medical Director of the Amputation Prevention Center at Valley Presbyterian Hospital in Los Angeles. He is a board-certified vascular surgeon with over 40 years experience and is a renowned specialist in the revascularization of diabetic limbs. Dr. Andros serves as the Co-Director of the Diabetic Foot Global Conference and is a member of the American Diabetes Association and the Society for Vascular Surgery.

   Dr. Lee is a consultant physician at the Amputation Prevention Center at Valley Presbyterian Hospital in Van Nuys, Calif. She is board certified in general and vascular surgery.

References
1. Granick MS, Newton ED, Futrell JW, Hurwitz D. The plantar digital web space island flap for reconstruction of the distal sole. Ann Plast Surg. 1987; 19(1): 68-74.
2. Kelikia AS and Sarrafian, S. Sarrafian’s Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional. Lippincott Williams & Wilkins, Philadelphia, third edition, 2011, p. 342.
3. Attinger CE, Evans KK, Bulan E, Blume P, and Cooper P. Angiosomes of the foot and ankle and clinical implications for limb salvage: reconstruction, incisions, and revascularization. Plast Reconstr Surg. 2006; 117(7Supp):261S-293S.

   Editor’s note: For further reading, see “Plantar Skin Flaps On Diabetic Ulcers: Are They Worth It?” in the March 2004 issue of Podiatry Today or “Pertinent Insights On Plastic Surgery And The Diabetic Foot” in the March 2011 issue.

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