Combined use of liposuction and arthroscopic shaver in lower-limb fasciocutaneous flap contouring.

The goals of reconstruction in the foot and ankle should be to restore ambulation and enable the patient to use normal footwear. In these wounds, free fasciocutaneous flaps provide pliable protection and gliding of tendons. There can however be problems with contour and bulk. We describe the combined use of liposuction and arthroscopic shaving to achieve effective flap contouring in a single session. We performed the technique in 10 free fasciocutaneous flaps in nine patients. The average interval between the initial reconstructive procedure and flap debulking was 7 months. Complications included two cases of flap superficial epidermal loss and one haematoma. At an average of 8.6 months follow-up, five patients reported that they were very satisfied with the procedure, three were satisfied and one was dissatisfied. Seven of the nine patients were using their original covered footwear at the time of follow-up. In conclusion, the combined use of liposuction and arthroscopic shaving is simple and effective in the contouring of fasciocutaneous flaps leading to good patient satisfaction and enabling the use of normal footwear.