Combined Pedicle and Free‐Tissue Transfer to Improve Functional Restoration of the Foot: The “Backpack Principle”

ABSTRACT

Reconstruction of weight-bearing areas of the foot remains a challenging problem for the reconstructive surgeon. The principle described involves the combination of an innervated regional pedicle flap providing sensate, durable coverage of the weight-bearing heel, and a microvascular fascia flap for thin, pliable coverage of a large surface defect, based on the same vascular bundle. This provides excellent long-term stability and minimizes the disruption of blood supply to the foot. The result after 3 years demonstrates that this concept may represent an interesting solution for these particular problems.