ID 109581
Author
Hashimoto, Ichiro Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Abe, Yoshiro Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Morimoto, Atsushi Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
Kashiwagi, Keisuke Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
Goishi, Keiichi Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
Nakanishi, Hideki Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
diabetic foot
foot ulcer
diabetic neuropathies
microsurgery
free tissue flaps
Content Type
Journal Article
Description
Background : Neuropathic diabetic foot ulcers are generally deep and infectious wounds extending to the bone or joint. We performed microsurgical free flap transfer for limb salvage and vascular augmentation of feet with diabetic neuropathy. Methods : Angiography was performed to identify any significant arterial disease. The free flaps were transplanted after resection of the damaged skin and infected bone. Flow-through or end-to-side anastomosis to the dorsalis pedis artery was performed to preserve the arterial blood flow to the residual foot. Results : An anterolateral thigh flap and free flaps based on the subscapular artery system were transplanted in 1 and 10 patients, respectively. All flaps survived. Arterial flow on the distal side of the anastomosis was postoperatively confirmed in all patients. During a mean follow-up period of 52 months, the long-term complications observed were recurrent ulcers in 4 patients. The limb salvage rate was 100%, and 82% of patients achieved functional ambulation. Conclusions : Microsurgical flap transplantation is a safe and useful technique for minimal amputation of a diabetic neuropathic foot. Postoperative protection of the feet is important in order to avoid recurrence of foot ulceration. The use of protective footwear custom-tailored for each patient is strongly recommended.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
61
Issue
3-4
Start Page
325
End Page
332
Sort Key
325
Published Date
2014-08
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
Medical Sciences
University Hospital