PMC4272413_01
Postoperative plain radiographs of the left foot showing the negative pressure wound therapy application over the surgical wound defect prior to the lesser toe fillet flap reconstruction. No osteomyelitis was noted on the preoperative plain radiograph of the left foot.
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F0001
The wound was subsequently left to heal by negative pressure wound therapy application (Fig. 1).
Yellow dotted line showing the direct lateral incision made over lateral aspect of fourth toe, exposing the fourth toe phalanges and metatarsal head. Black dotted line showing the original surgical wound defect prior to reconstruction.
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F0002
A direct lateral incision was made over the lateral aspect of the fourth toe from the tip of the distal toe to the metatarsal wound, exposing the phalanges of the fourth toe (Fig. 2).
(a, b) Filleted skin flap from lateral aspect of the fourth toe advanced laterally covering the exposed fourth metatarsal head.
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F0003
The filleted skin flap was then approximated laterally to the wound using a non-absorbable 4-0 Prolene suture, covering the exposed fourth metatarsal head (Fig. 3a and b).
Inset of a split-thickness skin graft onto remaining surgical wound defect secured using surgical staples.
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F0004
The STSG was then secured to the wound edges using staples (Fig. 4).