외측 흉부 조직 유리피판을 이용한 발바닥 재건의 결과 및 합병증

Abstract

Background: The complex structure of the sole makes repairing extensive defects challenging. This study examines the potential of the lateral thoracic free flap, including its versatile perforator options and chimeric configurations, as an advanced solution for comprehensive sole reconstruction, aiming to address the gap in current research. Patients and methods: From 2018 to 2022, a single surgeon at Hanyang University Medical Center performed lateral thoracic free tissue transfers on patients with sole defects from diverse causes. The study, excluding patients without postoperative outpatient follow-up or those treated without thoracodorsal artery perforator flap or latissimus dorsi free flaps, encompassed 54 individuals. Complications were meticulously recorded throughout inpatient stays and outpatient monitoring. Results: Among 54 patients, 34 were males, and 20 were females with an average age of 57. Infections were the leading cause of their conditions, followed by trauma, tumors, and posttraumatic sequelae. Most patients had preoperative comorbidities like hypertension and diabetes. The surgeries primarily involved thoracodorsal artery perforator flap reconstructions and more complex procedures in certain cases, tailored to individual needs. Postoperative follow-ups, averaging 14.8 months, revealed complications such as dehiscence and necrosis, managed through various treatments like secondary healing or surgical procedures. Despite these issues, the post-treatment recovery was generally successful. Conclusion: Sole reconstruction frequently necessitates the use of free tissue transfe r, owing to the inherent deficiency of local tissue availability. As evidenced by the outcomes of this study, while the lateral thoracic free tissue serves as a commendable choice for sole reconstruction there is a substantial risk of en suing complications, notably pressure ulcers. Consequently, meticulous postoper ative surveillance in an outpatient setting is crucial for the timely identific ation and management of such adverse effects. Keywords: sole reconstruction, lateral thoracic free flap