[Plastic surgery].
نویسنده
چکیده
VOL. 52 NO. 4 NOVEMBER 2014 SAJS 105 Plastic surgeons are frequently cal led upon to provide definitive softtissue coverage for lower l imb defects associated with compound fractures of the tibia or fibula (Gustillo-Anderson IIIB). Usually defects of the upper and middle thirds of the leg are easily managed with either gastrocnemius myocutaneous flaps or hemi-soleus muscle coverage and skin grafting (Fig. 1). Owing to limited laxity in the lower third, management of defects in this area has been more challenging. Historically even cross-leg flaps, with concomitant staging and the requisite immobility, have sometimes been required. More recently, microsurgical free flaps have featured early on reconstructive algorithms. Free flaps offer versatile and sufficient coverage without the limitations of the pedicle, and elevation and anastomosis can occur well beyond the zone of injury. Unfortunately, as a result of limited operating time and available consultant microsurgeons, only one free flap had been performed for this indication in the Groote Schuur Hospital complex (Cape Town, South Africa) over the 18 months leading up to the time of writing. Registrars have approached these challenges either by making use of negative-pressure dressings or expanding their armamentarium of local f laps. The most useful of these options has un doubtedly been the propeller flap. The propeller flap has become a versatile and important component in our reconstructive algorithm following complex lower limb trauma. First described by Hyakusoku in 1991, it has since been adapted and modif ied by Hal lock and Teo.[1-3] This article outlines our experience specifically with perforator pedicled propeller flaps (as per the Tokyo consensus[4]) for traumatic defects of the leg.
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ورودعنوان ژورنال:
- Ugeskrift for laeger
دوره 114 12 شماره
صفحات -
تاریخ انتشار 1952