Local fasciocutaneous flap skin coverage for the dorsal foot and ankle.

Recalcitrant wounds of the distal leg and foot are notorious for requiring complex solutions even when deceptively small or benign in appearance. The simplicity of local flap options is always preferable, but is limited about the dorsal foot and ankle region. Inclusion of the well-defined deep fascia with the overlying integument in this area permits creation of local fasciocutaneous flaps that may be an important viable alternative. Over the past 6 years, 13 patients have had 15 such fasciocutaneous flaps for ankle or dorsal foot soft tissue reconstruction, with vascular ischemia being the most common etiology. Although four major complications occurred (27%), no limb amputation was a sequela as local wound care was satisfactory for eventual healing. Seven of these patients (54%) either declined or technically were not candidates for a complicated microvascular tissue transfer, which usually would have been preferable, but nevertheless all results proved satisfactory.