Foot wound with exposed hardware; no evidence of contamination or osteomyelitis beyond the exposed area.
Right foot x-rays exhibited nonunion of the first metatarsal fracture and evidence of osteomyelitis.
Fig.2. Right dorsal foot wound. (Left) Following debridement and cement spacer placement, there was exposed antibiotic cement and bone. (Center) Bipedicled flap was raised as a skin flap adjacent to the wound. The dual dermal blood supply improved reliability and allowed for an increased length to width ratio compared to a standard unipedicled random flap. (Right) The flap donor site was skin grafted to minimize flap tension.