6. Vạt gan chân trong: Chất liệu lý tưởng cho tạo hình khuyết phần mềm vùng tỳ đè gan bàn chân

Abstract

The study evaluates the outcomes of using a medial plantar flap for soft tissue reconstruction of weight-bearing areas on the plantar foot. A non-randomized controlled interventional study was performed on 78 patients with soft tissue defects in weight-bearing areas of the plantar foot after melanoma excision at K Hospital from April 2018 to December 2023. Among the defects, 59 were located in the heel, and 5 in the midfoot and reconstructed using antegrade flaps. 14 defects in the toe and forefoot areas were reconstructed using 9 reverse flaps and 5 extended flaps. The smallest defect measured 4x4 cm, and the largest was 10x7 cm. At discharge, 96% of flaps survived fully, with partial necrosis observed in 2 antegrade flaps and 1 reverse flap. Postoperatively, 10 flaps experienced venous congestion, managed by gauze release and partial suture removal, with 7 of them recovering fully. At more than 6 months post-surgery, all flaps had a thickness comparable to the unaffected foot, patients can walk normally, can easily wear shoes, and had flap sensation. No case of pressure ulcer or graft site skin breakdown was observed. The results indicate that the medial plantar flap is an ideal reconstructive material for soft tissue defects in weight-bearing areas of the plantar foot, offering both good functional and aesthetic outcomes.