University Clinic of Plastic and Reconstructive Surgery Innsbruck, Anichstraβe 35, A-6020 Innsbruck, Austria

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Two cases of dorsal foot reconstruction using dorsal metatarsal V-Y advancement flaps based on dorsal metatarsal vessels are presented. The flap is useful for the repair of small to moderate sized dorsal foot defects.

Injuries to the distal part of the foot, or even the toes, can still provide reconstructive problems. It is not always wise to amputate the damaged, distal part of the foot. Some surgeons have stated that reconstruction of the distal foot is not necessary, but it is our opinion that it has a similar priority to reconstruction of the hand. While large defects are mostly reconstructed by free flaps, minor defects should also be considered for reconstruction. As in a previous paper, “Small toe muscles for defect coverage” [12], we are presenting a new way to reconstruct damaged tissue distal to the tarsometatarsal region.

The two inferiorly based rectus abdominis myocutaneous flaps are the most versatile and accessible flaps for high pelvic defects. Their primary contribution is in the obliteration of the pelvic "deadspace." At the present time, these useful flaps are generally considered only for massive defects of the perineum, groin, and pelvis, but improved flap designs will enhance their usefulness for smaller defects.

The de-epithelialized latissimus dorsi myocutaneous flap can be used for volume replacement of the subcutaneous mastectomy or unilateral hypoplasia, or for the replacement of the contracted prosthetic implant. Acceptable aesthetic results should be expected, and the permanence of the procedure is an improvement over the conventional silicone implant method of breast volume replacement. The procedure is applicable to both obese and thin patients, and should be considered as a reasonable alternative to the other methods of autologous replacement of lost breast tissue.