Foot and ankle reconstruction: pedicled XXXX versus free flaps and the role of @entity6 .

@entity1 @entity6 @entity3681 @entity7964 @entity121
BACKGROUND: The effectiveness of pedicled @entity121 versus microsurgical free flaps in @entity1 with @entity6 for complex foot and ankle reconstruction has not been well defined. METHODS: The Georgetown Wound Registry identified all @entity1 who underwent pedicled muscle flap or free flap reconstruction from 1990 to 2000 with 8.1    3.1-year follow-up. Thirty-eight @entity6 and 42 @entity7964 @entity1 were identified. Flap coverage was the reconstructive choice for defects with exposed tendons, joints, or bone, with pedicled @entity121 always selected for smaller defects. RESULTS: Thirty-two @entity1 received 34 pedicled @entity121 for 34 wounds, whereas 48 received 52 free flaps for 51 wounds. Thirty-one of 34 wounds covered with pedicled @entity121 went on to heal, for a 91 percent success rate, a 94 percent limb salvage rate, and a 78 percent @entity1 survival rate. There were 15 complications among 45 reconstructive procedures, for an overall 33 percent complication rate. Forty-eight of the 51 wounds covered with free flaps went on to heal, for a 94 percent healing rate, a 96 percent limb salvage rate, and a 77 percent @entity1 survival rate. There were 17 complications among 93 reconstructive procedures, for an 18 percent complication rate. CONCLUSIONS: @entity6 does not appear to affect the success of pedicled muscle flap or free flap reconstruction except for requiring more d  bridements, longer healing times, and decreased long-term survival. When compared with historical @entity6 controls with amputation, however, limb salvage appears to prolong survival of @entity6 @entity1 . Pedicled @entity121 appear to be as effective as free flaps for the coverage of small complex foot and @entity3681 , despite the postoperative complication rate. @entity6 is not a contraindication to either type of flap reconstruction for limb salvage. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.(Figure is included in full-text article.).
