DISTALLY BASED FLAPS FOR SKIN COVERAGE OF THE FOOT AND ANKLE

Skin loss about the foot and ankle is notorious for creating a difficu lt challenge for limb salvage, Local tissue rearrangements rarely prov e satisfactory, so a free flap as a solution can be readily justified, Distally based flaps utilizing unviolated ipsilateral proximal lower limb donor territories offer new possibilities in lieu of the complexi ty of microsurgery, Yet some unique disadvantages must be acknowledged particularly for island flaps, depending on retrograde circulation vi a major collateral source vessels, where venous congestion can occur a nd risk of limb devascularization may be unacceptable, Antegrade perfu sed, distally based flaps nourished by a single septocutaneous perfora tor or communicating branches may be more reliable options, This intro duction to these three potential types of distally based lower extremi ty flaps is intended to promote this concept with appropriate reservat ions as another relatively simple alternative for wound coverage in th e lower extremity.