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CC BY 4.0 · Arch Plast Surg 2025; 52(05): 310-316
DOI: 10.1055/a-2635-2680
Extremity/Lymphedema
Case Report

Reconstruction of a Complex Foot Defect with a Chimeric Triple-Component Osteocutaneous SCIP–SIEA Free Flap: A Case Report and Literature Review

Yanis Berkane 
1   Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire de Rennes, University of Rennes, Rennes, France
2   SITI Laboratory, UMR1236, Etablissement Français du Sang, University of Rennes, Rennes, France
,
Elise Lupon 
3   Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, Nice, France
7   Laboratory of Molecular PhysioMedicine (LP2M), UMR 7370, CNRS, University Côte d'Azur, Nice, France
,
Pierre Muret 
4   Department of Orthopaedic Surgery, Centre Hospitalier Universitaire Lapeyronie, University of Montpellier, Montpellier, France
,
Jérôme Laloze 
5   Department of Maxillo-Facial, Plastic and Reconstructive Surgery, Dupuytren University Hospital, Limoges, France
,
Nicolas Bertheuil 
1   Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire de Rennes, University of Rennes, Rennes, France
2   SITI Laboratory, UMR1236, Etablissement Français du Sang, University of Rennes, Rennes, France
,
Christian Herlin 
6   Department of Plastic Reconstructive Surgery and Burns, Centre Hospitalier Universitaire Lapeyronie, University of Montpellier, Montpellier, France
,
Paul Girard    *
1   Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire de Rennes, University of Rennes, Rennes, France
2   SITI Laboratory, UMR1236, Etablissement Français du Sang, University of Rennes, Rennes, France
,
Hadrien Paoli    *
6   Department of Plastic Reconstructive Surgery and Burns, Centre Hospitalier Universitaire Lapeyronie, University of Montpellier, Montpellier, France
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Abstract

Complex defects resulting from infected bone or joints with or without osteosynthesis or prosthetic material lead to significant challenges that need to be addressed through orthoplastic approaches. Foot and ankle reconstruction is particularly difficult due to the lack of local or regional flap solutions in this highly mobile joint, which often necessitates microsurgical flaps in extended defects. In addition, rigorous bone reconstruction is critical to acute bone infection to minimize the risks of functional impairments. We present a novel approach using a chimeric osteocutaneous flap to address a complex calcaneus fracture with extended postoperative skin necrosis and septic pseudoarthrosis. A dual skin paddle (16 × 6.5 cm and 14 × 4.5 cm) was created using a superficial inferior epigastric artery (SIEA)-to-superficial circumflex iliac artery (SCIA) anastomosis, while the 7-cm pedicle was increased using a deep inferior epigastric artery graft, which was anastomosed to the tibial anterior vessels. The vascularized iliac crest component enabled optimal reconstruction of the bone defect with rapid healing, while the combined SCIP (superficial circumflex iliac artery perforator)–SIEA skin flap was used to cover the bone reconstruction and skin defect. This microsurgical reconstruction allowed optimal functional recovery at 12 months with successful bone integration and soft tissue coverage. The step-by-step intraoperative technique is described through [Video 1] and [Supplementary Video 2].

Keywords

foot reconstruction - SCIP flap - chimeric flap - ankle reconstruction - SIEA flap

Authors' Contributions

Conceptualization: P.G., H.P.

Data curation: Y.B., P.M., P.G., H.P.

Formal analysis: Y.B., E.L., N.B., C.H., J.L.

Methodology: N.B., C.H., P.G., H.P.

Project administration: N/A

Visualization: Y.B., P.M., P.G., H.P.

Writing — original draft: Y.B.

Writing — review and editing: all authors.


Ethical Approval

All clinical care was compliant with the principles of the Declaration of Helsinki (1964) and the French Bioethics Law (2011).


Patient Consent

Informed consent was obtained from the patient for the use of his medical record, photographs, and videos.


* These authors shared senior authorship.


Supplementary Material



Publikationsverlauf

Eingereicht: 29. Januar 2025

Angenommen: 08. Mai 2025

Accepted Manuscript online:
16. Juni 2025

Artikel online veröffentlicht:
01. September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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