Lower limb re-vascularization based on the angiosome concept with immediate-early local flap reconstruction: a case report

Lower extremity wounds are a healthcare issue that can result in debilitating consequences. Peripheral arterial occlusive disease (PAOD) being a major contributing factor to the disease, advance revascularization procedures (Angioplasty) based on the angiosome concept has been established in the literature to improve blood supply and promote better healing outcomes. We present a case of a 59-year-old lady with background of hypertension, diabetes and PAOD, was diagnosed with a non-healing foot wound with exposed metal implant. She had targeted angioplasty done based on angiosome concept followed by early local flap reconstruction for coverage, which healed well without complications. Although free tissue transfer has now been the mainstay for lower limb reconstruction with the advancement in microsurgery. Local flaps remain in the armamentarium of lower extremity reconstruction with small to medium sized wound defects. This case demonstrates the advantage of proceeding with immediate-early local flap reconstruction following successful targeted re-vascularization.