Objective To access the clinical utility of miniature free Flap to repair multi-digit soft tissue defect. Methods From June 2015 to June 2017, 9 cases of soft tissue defect in 26 digits were treated with multiple miniature free flap reconstructions, including 2 digits defect in 3 cases using bilateral fibular flap of the toe, 3 digits defect in 4 cases using bilateral fibular flap of the toe plus uniliateral medial pedal flap and 4 digits in 2 cases using bilateral fibular flap of the toe plus biliateral medial pedal flap. The doner site were directly closed in all cases. Results All flaps survived postoperatively without vascular crisis. Donor and recipient sites healed by first intention. With a mean follow-up of 18 months (ranged 3～24 months), all free flaps appeared to be in good texture, elasticity and aesthetics. According to CMAHS upper extremity scoring system, postoperative hand function were rated excellent in 21 cases, good in 4 cases and poor in 1 case. Static 2 point discrimination was 7.5 mm (ranged 6 mm～9 mm). Conclusion We can achieve a satisfactory long -term aesthetic and functional outcome of multiple digital soft tissue reconstruction using miniature free flap.

Objective To report clinical outcomes in the treatment of infected soft tissue defects in the heel by peroneal artery perforator flap transfer. Methods From January 2011 to June 2013, infected soft tissue defects in 13 heels were treated by peroneal artery perforator flaps, among which 1 flap carried small saphenous vein and sural nerve. Before the transfer of the flap, infected heels had debridement followed by vacuum sealing drainage ( VSD ) and irrigation with sensitive antibiotic solution until the wound presented with a negative bacterial culture. Results All the 13 flaps survived completely. A follow-up of 3-24 months revealed that the flaps transferred onto the heels had good color without scar contracture, ulceration or sinus. Flaps regained basic protective sensation 12 months after operation. American Orthopaedic Foot and Ankle Society ( AOFAS ) scoring system was used to evaluate the ankle function ( good-excellent rate: 84.6% ): excellent in 8 cases, good in 3, fair in 1, poor in 1. Conclusions Transfer of a peroneal artery perforator flap after debridement and VSD in the recipient wound is an effective method in the treatment of infected heel soft tissue defect.