Free cMSAP flap for the treatment of chronic osteomyelitis with complex soft tissue defects in foot and ankle

Chronic osteomyelitis is very difficult to treat, numerous reconstructive strategies have been described for repairing soft tissue defect combined with chronic osteomyelitis in the foot and ankle. The free chimeric medial sural artery perforator (cMSAP) flap has been recommended for reconstructing the complicated wounds. We conducted a retrospective study on 16 patients who accepted cMSAP flap to reconstruct the soft tissue defect in the setting of chronic osteomyelitis in foot and ankle from January 2021 to December 2023. The effect of surgery and the functional evaluation of the limb were assessed. Results displayed that no chronic osteomyelitis was recurrent, no cases needed bulky flap defatting and the functions of the lower extremity were all improved at the last follow-up. The free cMSAP flap is a good alternative for reconstructing complex soft tissue defects with deep dead space in the setting of chronic osteomyelitis in the foot and ankle.