Title: In pursuit for the “ideal” free flap in diabetic foot reconstruction.

Biography:

Ali Adil Mahmud is a Professor in Aligarh Muslim University, India. His Specialization is in Plastic and Reconstrauctive Surgery.

Abstract

Introduction

Diabetic foot ulcers have troubled surgeons for generations and still continue to do so. Setting a balance between adequate wound healing, maintaining joint movements  and wearing foot wear are some of the ideal end points of surgery.

With the advent and proven safety of free flaps the plastic surgeon is equipped with a unique armamentarium to treat these problematic wounds.

Various free flaps have been described with various advantages and disadvantages ,in this study we analyse why free gracillis muscle transfer is one of the most “ideal” free flaps in diabetic foot ulcers.

 

 Materials and methods:

This is a retrospective study done over a period of 2 years. A total of 37 patients with diabetic foot ulcers were operated by a single surgeon. Total operation time, wound healing, donor and recipient site complications and ability to wear footwear were recorded.

Results:

The majority of patients were male. 12  patients had wounds  on the dorsum of foot, 10 on the fore foot, 8 on the ankle and 7 patients had ulcers on the sole of foot.

There was complete flap take in 30 patients, partial flap loss in 5 and complete flap loss in 2 patients. The average operation time was 180+/-35 minutes, with  minimal donor site complications and no repeat procedure was required in the majority for footwear adjustment.

Conclusion

Gracillis flap can be considered as an “ideal” free flap in small to medium sized diabetic foot ulcers.