A Review of Local Soft Tissue Coverage Options for Oncologic Defects of the Distal Lower Extremity

Abstract The distal third of the lower extremity has historically been a challenging anatomic region to provide durable soft tissue coverage following significant trauma or oncologic resection. This is due to the paucity of locoregional tissue. At times, wound coverage is the rate limiting factor in attempts at limb salvage, and the pendulum has swung from amputation to utilization of free tissue transfer as these techniques have developed over the years. The most recent published novel techniques in reconstruction of this area have instead utilized local tissue options rather than their free flap counterparts. The potential benefits of choosing these alternatives in the appropriate patient selection include less donor site morbidity, less operative time, ability of more healthcare facilities to provide reconstruction if not equipped for free flaps, and preservation of other sites if they are needed for in the setting of disease progression. This provides a review of the most common and reliable locoregional options for the distal leg, ankle, and foot.