Horn-Shaped Perforator Flaps for Plantar Reconstruction in Diabetic Foot Ulcers
Summary: This review evaluates the use of horn-shaped perforator flaps for reconstructing plantar defects after debridement of diabetic foot ulcers. The technique provides like-with-like tissue (sensate, glabrous skin) with reliable blood supply from perforators, resulting in durable weight-bearing surfaces, reduced shear forces, and lower ulcer recurrence compared to skin grafts or free flaps. The authors discuss patient selection, surgical pearls, and outcomes in high-risk diabetic populations. It represents an important reconstructive option in limb salvage algorithms for deep plantar wounds.
Key Highlights:
- Horn-shaped design preserves sensation and provides robust plantar coverage
- Lower recurrence rates versus traditional grafting methods
- Useful in selected DFU cases after thorough debridement and vascular optimization
Keywords: perforator flap plantar, diabetic foot reconstruction, limb salvage flap