Effectiveness of reverse first dorsal metatarsal artery flap for reconstruction of distal foot in electrical injuries

Introduction: The severity of electrical injuries depends on the voltage, the duration of exposure to current, and the trajectory of the current through the body. The reconstruction for defects caused by electric current is a difficult process.

Objective: The purpose of this study is to investigate the effectiveness of the reverse first dorsal metatarsal artery (FDMA) flap in the reconstruction of distal foot injuries caused by electric currents.

Method: This is an observational and descriptive study. Reverse FDMA flaps were used in 21 patients with defects in the distal of their feet as a consequence of electrical injuries, and their outcomes were observed. Descriptive statistical methods were used in the analyses of the data.

Results: While 57.1 % of the patients were between 18 and 35 years old, 3 patients were children, and 81 % of the patients were male. The site of the defect was the right sole/dorsum in 33.4 % of the cases and the right great toe in 28.6 %. Twenty patients (95.6 %) were exposed to high-voltage electric current. The dimensions of the defects of 42.9 % of the patients were 5-8 cm × 2-4 cm. Wound dehiscence was seen in 1 diabetic patient, and superficial flap necrosis developed in a young male patient with no health problems other than his electrical injury. Angiography was not performed on any patient.

Conclusion: The reverse FDMA flap is a safe and effective method for the reconstruction for electrical injuries developing in the distal foot in which one-stage surgery is sufficient. We recommend the usage of the reverse FDMA flap for the closure of soft tissue defects caused by electrical injury in the sole, dorsal region of the foot, and great toes.