Perforator-based Pacman Flap in the Plantar Region

• Published in: The Journal of foot and ankle surgery Vol. 50; no. 6; pp. 747 - 750
• Main Authors: Kim, Hyungsuk, MD, Pyon, Jai Kyong, MD, Lim, So Young, MD, Mun, Goo Hyun, MD, Bang, Sa Ik, MD, Oh, Kap Sung, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2011; Elsevier
• Subjects: Adult; Aged; artery; Biological and medical sciences; cancer; Carcinoma, Basal Cell - pathology; Carcinoma, Basal Cell - surgery; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Cohort Studies; Diseases of the osteoarticular system; Female; Follow-Up Studies; foot; Foot - surgery; Foot Diseases - pathology; Foot Diseases - surgery; Humans; Male; malignant; Medical sciences; Melanoma - pathology; Melanoma - surgery; Middle Aged; neoplasm; Orthopedics; Reconstructive Surgical Procedures - methods; Retrospective Studies; Skin Neoplasms - pathology; Skin Neoplasms - surgery; surgery; Surgical Flaps - blood supply; Treatment Outcome; Wound Healing - physiology; 4; cancer; neoplasm; artery; malignant; foot; surgery; Foot sole; Treatment; Surgery; Orthopedics; Free flap; Malignant tumor; Artery; Cancer; Foot
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2011.06.011

Abstract Numerous techniques have been used to reconstruct the plantar area to preserve the function of both recipient and donor sites and to produce satisfying results. We describe a method of plantar soft tissue reconstruction using a perforator-based Pacman flap to cover the circular defects after wide excision in cases of plantar malignancy. Eight patients who underwent plantar reconstruction between September 2008 and February 2011 were reviewed in the present study. Of the 8 patients, 6 had malignant melanoma, 1 had basosquamous basal cell carcinoma, and 1 had squamous cell carcinoma. Medial (5 patients) and lateral (3 patients) plantar artery perforator-based Pacman flaps were used. All flaps provided satisfactory coverage of the soft tissue defects in the plantar region, and all patients achieved a good functional outcome after a mean follow-up of 13 (range 2 to 22) months. The median patient age was 54 (range 26 to 67) years. The median maximum diameter of the circular defects was 40 (range 20 to 70) mm, and the mean operative time was 65 (range 50 to 120) minutes from flap elevation to wound closure. We believe that good functional outcomes and minimal complications can be achieved when the perforator-based Pacman flap is used for plantar reconstruction. Furthermore, the full extent and utility of this method of plantar reconstruction remains to be determined.