Background: Owing to the limited soft tissue donor sites in the foot area, the use of microsurgical
tissue transfer is frequently becoming mandatory in this area, especially in cases of massive
defects due to the common motor vehicle accidents in the territory of Upper Egypt. Free flaps offer
a great variety of available tissues to cover larger, multifocal or multistructural defects. They also
improve the perfusion of the infected poorly perfused areas. Objectives: In this study, we tried
to evaluate foot defects according to their size, shape and site and to determine the general and
specific parameters of free tissue transfer to the foot area in concomitance with the patients needs.
Materials and Methods: Eleven patients were included in this study. For each patient, complete
history was taken, general and local examination, photographic documentation, laboratory
investigations, imaging and other investigations were performed. Free flap transfers were
applied in all cases as follows: Latissimus dorsi flap in five cases, Rectus abdominis flap in three
cases, Scapular flap in one case, Gracilis flap in one case and Radial forearm flap in one case.
Results: Nine flaps survived. No infection or donor site complications were recorded. Every patient
had the optimum free flap as regards the defect size, site, depth, condition, shape, donor site
availability and the recipient vessels condition. Conclusion: The study of the optimum free flap
for foot reconstruction in relation to the defect present and patient conditions is crucial to have
significant results.