{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:07:20Z","timestamp":1782886040870,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2011,10,18]],"date-time":"2011-10-18T00:00:00Z","timestamp":1318896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2011,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background: Large or extensive gouty tophi on the feet can cause functional impairment, drainage sinus, and infected necrosis, finally resulting in complex soft\u2010tissue defects with tendon, joint, bone, nerve, and vessel exposure. Reconstruction of complex soft\u2010tissue defects of the foot is still challenging. The purpose of this report was to review the outcomes of free\u2010flap reconstructive surgery for treating the metatarsal joint defects of the feet caused by chronic tophaceous gout. Methods: Ten patients who had large tophus masses (&gt;5 cm) and ulceration on the feet were admitted to our hospital between September 2006 and September 2010. Six patients underwent free\u2010flap reconstruction after debridement to resurface the circumferential wound, protect the underlying structures, and provide a gliding surface for exposed tendons. The patients' age, sex, comorbidities, location and size of the defects, reconstructive procedures, surgical outcomes, complications, follow\u2010ups, and recurrence of tophaceous gout were reviewed and recorded. Results: The mean patient age was 49.8 years (range, 36\u201372 years). The average skin defect size was 92.2 cm<jats:sup>2<\/jats:sup>. Five patients were treated using free anterolateral thigh flaps, and 1, using a free medial sural flap. These free flaps were safely raised and showed excellent functional and cosmetic results, with a mean follow\u2010up of 31.7 months (range, 7\u201350 months). Conclusion: Chronic tophaceous gout can cause severe skin infection and necrosis, even resulting in deformity or sepsis if left untreated. Surgical debridement is inevitable in patients with extensive wounds. We reconstructed the large, ulcerative skin and soft\u2010tissue defects on the dorsum of the foot by performing free\u2010flap reconstruction after adequate debridement and achieved good functional and cosmetic results. \u00a9 C 2011 Wiley Periodicals, Inc. Microsurgery, 2011.<\/jats:p>","DOI":"10.1002\/micr.20949","type":"journal-article","created":{"date-parts":[[2011,10,18]],"date-time":"2011-10-18T12:47:16Z","timestamp":1318942036000},"page":"610-615","source":"Crossref","is-referenced-by-count":17,"title":["Free\u2010flap resurfacing of tissue defects in the foot due to large gouty tophi"],"prefix":"10.1002","volume":"31","author":[{"given":"Chin\u2010Ta","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun\u2010Chen","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim\u2010Mo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niann\u2010Tzyy","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju\u2010Peng","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shou\u2010Cheng","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan\u2010Sheng","family":"Tzeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyi\u2010Gen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,10,18]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"160","article-title":"The medical\/surgical management of gout","volume":"25","author":"Landry JR","year":"1986","journal-title":"J Foot Surg"},{"key":"e_1_2_6_3_2","first-page":"1501","article-title":"The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study","volume":"27","author":"Lin KC","year":"2000","journal-title":"J Rheumatol"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.SAP.0000067723.32532.97"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197007000-00008"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-82-10-514"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0007-1226(87)90087-7"},{"key":"e_1_2_6_8_2","first-page":"269","volume-title":"Abductor Hallucis Muscle Flap. 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