DORSALIS-PEDIS FLAP DONOR SITE - ACCEPTABLE OR NOT

The dorsalis pedis flap has been used successfully for 20 years, both as a pedicled transfer for local foot reconstruction and as a free mic rovascular transfer. Proponents cite the reliable vascularity, versati lity, ease of harvest, and thinness. Although significant donor-site m orbidity has been recognized previously, published reports have inadeq uately documented the long-term effects of dorsalis pedis flap harvest . The purpose of the present study was to obtain long-term follow-up d ata regarding the donor site on a total of 10 male patients who underw ent dorsalis pedis flap harvest during the period from 1982 to 1984. S tandardized questionnaires and chart reviews were completed, and physi cal examinations and photographs of each patient were carried out when possible. Eight patients were reviewed, and seven of them were examin ed and photographed (mean follow-up 13 years). All patients had initia lly experienced delayed donor-site healing (mean 18 months; range 3 to 36 months). In addition, soft-tissue infections (five of eight cases) , osteomyelitis tone of eight cases), wound breakdown (seven of eight cases), scarring and contracture (four of seven cases), pain or other uncomfortable sensations in the foot (six of seven cases), and require ment for reoperation (three of eight cases) were significant complicat ions of the procedure. Most patients were able to attain their preoper ative level of physical activity (five of eight cases). Although gener ally favorable reconstructive results were obtained in this series, th e long-term follow-up of donor-site healing indicates that this flap s hould be used with caution. In particular, delayed donor-site healing, need for wound revision, and long-term and possibly permanent donor s ite symptoms are common.