Repairing diabetic foot wounds is challenging due to the high risk of necrosis associated with traditional skin flap techniques. This report introduces a novel separation-delayed flap technique and elaborates on its application in treating diabetic foot ulcers. A 54-year-old Chinese male patient was diagnosed with diabetic foot ulceration, exhibiting a 4 cm × 3 cm full-thickness skin defect on the lateral aspect of the left ankle, with exposed fibular cortex and extension into the tibiotalar joint cavity. Upon admission, the wound underwent debridement followed by antibiotic-impregnated bone cement placement, and 3 weeks later, a conventional peroneal fascia-based flap was created, then isolated using a rubber membrane, and sutured in situ. Following 10 days of isolation, the flap was excised and transferred to the defect site for wound repair. Postoperatively, the skin flap survived entirely, the wound healed successfully, and the function of the skin flap returned to normal. Separation-delayed skin flap technique increases the survival rate of skin flaps by incrementally improving blood supply, making it an effective option for repairing diabetic foot wounds.
Guan et al. (2026) studied this question.