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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/8851

Title: Wound coverage of plantar metatarsal ulcers in leprosy using a toe web flap
Authors: Joshua, J
Chakraborthy, V
Keywords: Plantar metatarsal ulcers, Plantar metatarsal artery, Digital artery, Leprosy, Toe web flap
Issue Date: 31-Dec-2005
Publisher: Medknow Publications on behalf of Indian Journal of Plastic Surgery
Citation: Indian Journal of Plastic Surgery (ISSN: 0970-0358) Vol 38 Num 2
Abstract: Plantar metatarsal ulcers and sinuses are frequently seen problems in anaesthetic feet in leprosy. They may occur singly or as multiple sinuses. Many flaps have been described in the management of small defects of the forefoot. During the course of four years, from March 2000 to February 2004, a total of 708 plantar metatarsal ulcers in anaesthetic feet due to leprosy were seen. 280 surgeries were performed on 257 cases. Most of these were debridement and or excision of the metatarsophalangeal joints through a dorsal incision. Thirteen cases were dealt with by a toe web flap, using the plantar metatarsal artery as the source of supply to the flap. Nine were to cover defects under the 1st metatarsophalangeal joint. Three were to cover defects under the second and third metatarsophalangeal joints and one involved coverage of a defect under the 5th metatarsophalangeal joint. In all cases except the last, the big toe contributed the flap. In the last case the fourth toe was the donor. In all cases the flaps survived and did well. The secondary defects were covered with split thickness skin graft. Wound dehiscence was seen in one case and recurrence of a sinus, was seen in one case. Hyperkeratosis of the secondary defect was seen in three cases. Follow up ranged from 3 years to six months. We found this flap to be durable and safe with little chance of recurrence when used to cover plantar metatarsal ulcers.
URI: http://hdl.handle.net/1807/8851
Other Identifiers: http://www.bioline.org.br/abstract?id=pl05025
Rights: Copyright 2005 Indian Journal of Plastic Surgery.
Appears in Collections:Bioline International Legacy Collection

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