Propeller Flaps in Lower Limb Reconstruction: Case Series
نویسندگان
چکیده
Introduction: Traditionally in reconstruction of lower limb soft tissue defects, muscle flaps have been the ‘Gold Standard’ for Gustillo Anderson Grade III B fracture involving upper and middle third defects. Lower third defects were usually reconstructed with free flaps. Evolution in flap surgery has enabled fasciocutaneous, adipofascial and superthin flaps to be harvested for the purpose of reconstruction thereby minimizing morbidity from muscle inclusion into the flap. We present our experience with perforator (propeller) flaps for reconstruction of soft tissue defects in the lower limb. Materials and methods: Between February 2010 and April 2010, 6 consecutive patients, 34 years (18-50 years old), were referred to our services post trauma to the lower extremity. This case series consists of patients from two separate centers in Malaysia. All wounds were classified as Gustillo Anderson Grade IIIB. All patients were operated under spinal anaesthesia. Perforators were identified and traced to major limb vessel and skin paddle was designed around the perforator. Skin paddle was then rotated into the defect in the lower third of the leg. Results: All the patients tolerated the procedure well. There was one case of epidermolysis, however the remainder of the flap survived and wound healed completely. Two flaps based on the peroneal artery initially underwent distal congestion but however improved on day three post-operatively. All six flaps survived 100% post inset for middle and distal third leg reconstruction. Conclusion: Propeller flaps in our experience is a versatile option for reconstruction of lower leg soft tissue defects with associated Grade IIIB open fractures. Figure 1: Anterior tibial defect with flap design and perforator markings as shown. Figure 2: Flap rotated on its perforator to cover defect. Donor site grafted with split skin graft. Anaplastology An aplogy
منابع مشابه
Perforator Flaps for Reconstruction of Lower Limb Defects
BACKGROUND Reconstruction of soft tissue defects in the lower third of the leg remains challenging. Anatomical constraints limit the local options available for complex defects especially lower third of leg. Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. We present our experience with perforator flaps for reconstruction of soft tissue def...
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