Sequential therapy of debridement, vacuum sealing drainage and latissimus dorsi free- flap reconstruction for extensive soft-tissue injury with multiple fracture of left foot.

Abstract

Foot injuries are common .The usual mode of injuries are road traffic accidents, fall of heavy object, crushing between moving objects etc. They often result in complex tissue loss with exposed bones and tendons requiring reconstruction aimed at restoring form and function. The stress and strain of weight bearing, ambulation, activities of daily living, and occupation have to be considered while planning. These three-dimensional defects ideally require flexible well-perfused flaps to fill the space, afford resistance to infections, and to provide supple, durable weight- and pressure-bearing surfaces. Microsurgical free muscle flaps with split thickness skin graft cover have been found to have several advantages in covering such defects.1 Skin grafted muscle flaps are the first choice for post-traumatic defects of the foot and leg 2. Modern protocols for limb salvage surgery in combat injuries have included early flap covers to limit the number and extent of amputations.3,4