Degloved foot sole successfully reconstructed with split thickness skin grafts

Abstract

Introduction: The current opinion is that split thickness skin grafts are not suitable to reconstruct a degloved foot sole. The tissue is too fragile to carry full bodyweight; and therefore, stress lesions frequently occur. The treatment of choice is the reuse of the avulsed skin whenever possible, or else the use of a full thickness fascio-cutaneus flap.

Presentation of the case: A young male sustained a crush injury to his right foot with deglovement of the plantar surface and part of the dorsum.

Discussion: Split thickness skin grafts are not suitable for full weight bearing, but in special circumstances, certain patients, a lot of time and patience, early mobilization and gradual increasing partial weight bearing it is worthwhile to try. To toughen the foot sole pressure distribution is necessary and can be reached in several ways, soft and springy materials of the inlay, but also socks, orthopedic shoes, casting, orthotics or walking aids.

Conclusion: This case-report illustrates that the reconstruction of a degloved foot sole with split-thickness skin grafts can be successful; a silicon inner sole was used to prevent stress lesions.

Keywords: Case report; Foot sole; Functional outcome; Reconstruction; Split thickness grafts; Thiersch.