THE USE OF A FREE MEDIALIS-PEDIS FLAP FOR RESURFACING SKIN DEFECTS OF THE HAND AND DIGITS - RESULTS IN 5 CASES

A free medialis pedis flap was used to repair skin defects of the fingers and hand in five patients, the nap sizes ranging from 2 X 3 cm to 5 X 10 cm. Four flaps survived completely, but the largest flap turned necrotic along the dorsal margin, which is thought to have resulted from an incorrect flap alignment. A free medialis pedis nap possesses several advantages: (1) It is very thin in comparison with other standard free naps; (2) it can be used for small repairs, unlike many conventional free flaps; (3) it possesses two draining venous pathways, the vena comitans and the subcutaneous veins; (4) the diameters of its vessels are similar to those of the fingers; (5) it provides a good color and texture match for finger repairs; and (6) a good recovery of protective sensation is achievable, probably due to its thinness. However, this flap also has some disadvantages: A. skin graft is usually required for donor-site closure, and it cannot be used as a sensory flap.