Reconstruction of a soft tissue defect in the toe using a serratus anterior fascia free flap

Toe injuries frequently occur as traumatic or oncologic defects. Compared with finger reconstruction, toe reconstruction has been rarely reported in the literature, because of the difficulty of toes’ relatively thin soft tissue envelope, their requirement for relatively challenging surgical techniques, and the slight improvements in gait. Therefore, toe reconstruction can be challenging for plastic surgeons, especially in cases with exposure of a tendon, bone, or joint. Herein, we present a case study of a 54-year-old woman with squamous cell carcinoma in situ (Bowen disease) that subsequently resulted in a defect on her second toe. A serratus anterior fascia free flap could be a good option for toe reconstruction due to its large caliber, lengthy pedicle, relatively easy dissection, and thin muscle bulk. We present our unique experience using the serratus anterior fascia free flap for the reconstruction of an oncologic toe defect.