The use of a free medialis pedis flap for resurfacing skin defects of the hand and digits: results in five cases.

A free medialis pedis flap was used to repair skin defects of the fingers and hand in five patients, the flap sizes ranging from 2×3 cm to 5×10 cm. Four flaps survivedcompletely, 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 flap possesses several advantages: (1) It is very thin in comparison with other standard free flaps; (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