Effectiveness of the gastrocsoleous flap for coverage of soft tissue defects in leg with emphasis on the distal third

Introduction: The standard methods for reconstruction of soft tissue defects in legs are gastrocnemius flap for proximal third defects, soleus flap for middle third and free flap in the distal third. However, there are problems with the use of free flap, like increased operative time, damage of major vessels and the need for experienced microsurgeon. In this study we examined the ability of the gastrocsoleous flap for coverage of leg soft tissue defects. Methods: This cross-sectional study was undertaken on 23 patients (20 male and 3 female) with the mean age 32.13 years (14 to 65). This group consisted of all of the patients referred to Dr Bahonar Hospital, Kerman with soft tissue defects between April 2011 and April 2012. They were given informed consent for participation in the study and treatment of the defect with muscle flaps. 8 patients with proximal third defects were treated with were treated with gastrocnemius flap, 4 with middle third defects with soleus flap and 3 with reverse soleus flap and 8 with distal third defects with reverse soleus flap. The patients were followed up for at least 1 year. Finally the results were analyzed by SPSS 16. Results: The results for patients with soft tissue defect in proximal and middle third of leg repair was successful. In 5 patients with soft tissue defect in distal third of leg, repair was complete but, in 3 of them flap failure was seen. Overall success rate for reverse soleous flap was 72.7%. Conclusion: The success rate of the flap for the upper and lower thirds was similar to other studies and seems that this is the standard method. In the upper half of distal third reverse soleous flap was successful, but in the lower half of the leg it failed in all 3 cases and it seems that preoperative investigations such as angiography must be performed before embarking on such a procedure.