The V Advancement Flap Sans Y Closure in Treatment of Volar Foot Ulcers

Abstract

Background: Management of foot ulcer is challenging for plastic surgeons owing to inherent sturdiness of the volar skin and also the necessity to give a robust cover to ensure functionality including weight bearing. This study was conducted to examine the results of our technique of single or double ‘V’ advancement flap sans the ‘Y’ closure of the classical ‘VY’ flap, which was found to be technically simple for the management of plantar ulcers in our foot ulcer patients. Methods and Material: 37 patients hospitalized for the management of foot plantar ulcer, who underwent repair with our modified ‘V’ flap advancement without ‘Y’ closure technique, at our institution were included in the study. Demographic data, disease-related parameters, technique related complications data were recorded and analysed. Technique complications or sequelae, if any, were accounted. Descriptive statistics was used to summarize the findings. Results: In our study, 23 men and 14 women were there with their ages ranging from 15 to 87 years (mean = 54.1 years). The diameter of the ulcers ranged from 14 to 26 mm with mean of 19.3 mm. Unilateral V (-Y) advancement flap was used in 26 cases and in 11 cases bilateral V (-Y) advancement flap was used. Complications included wound dehiscence (3) and partial flap loss (1) of which 3 required redo surgeries while one healed with secondary intention. Conclusions: Though a relatively small study group our technique well suited the needs for plantar ulcer wound closure with acceptable complication rate. Key Messages: Foot ulcer management is a therapeutic challenge which, if managed efficiently reduces encumbrance. Our technique represents a useful and reliable technique with advantages of excellent colour and texture matching and primary donor site closure. Keywords: VY advancement flap, Plantar foot ulcer, Diabetic ulcer, Malignant foot ulcer, Trophic ulcer, Traumatic ulcer