ROLL OF LOCAL FLAP TECHNIQUE IN THE MANAGEMENT OF COMPOUND INJURIES OF LEG
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i5.49707Keywords:
Fasciocutaneous flap, Muscle flap and musculocutaneous flap, SSG split skin graftAbstract
Objective: The objective of this study was to study the feasibility of local flaps in management of soft-tissue defects with exposed fracture bone fragments in lower extremity (particularly the leg) due to trauma.
Methods: The present study included 20 cases of traumatized lower extremity having a soft-tissue defect and an exposed bone with or without associated fractures. Study was conducted from January 1989 to August 1990. Local flaps provide a reliable single stage procedure for coverage of lower extremity soft-tissue defects. Distant flap provides good coverage but these procedures are long drown out and tedious. Only those cases were selected in which wound was found to be preferably, in the upper 1/3rd, middle 1/3rd and the upper most part of the lower third of the leg due to easy accessibility and placement of the flaps to these area. (As flaps can easily be transposed to these areas). All flaps, that is, Fasciocutaneous, Musculocutaneous, or local Muscle flaps were under taken as a delayed procedure after careful evaluation of traumatized limb, that is, repeated dressing, debridement and control of infection.
Results: In this study, stable wound coverage was achieved in all patients. Most of the patients were in the age group of 18 to 42 (55%), of these 90% were male. The longest duration of follow-up was 14 months and shortest was 3 months. Excellent result were obtained in Muscle and Musculocutaneous flaps while good result was obtained in 10% cases of Fasciocutaneous flap.
Conclusion: Stable coverage can be achieved by flap techniques using Fasciocutaneous Muscle of Musculocutaneous flaps. Coverage of exposed cartical bones, tendon and major vessels and adequate control of infection can be achieved by Muscle and Musculocutaneous flap in post traumatized limb. Fasciocutaneous flap (Ponten super flap) is very useful in repair of soft-tissue defect asit is a much simpler, easy to design and construct large flaps are safe due to good circulations, requires less time without any functional loss. Post-operative management is simple for both patient and staff.
Downloads
References
Arnald PG, Irons GB. Lower extremity muscle flaps. Orthop Clin North Am. 1984;15(3):441-9.
Mathes SJ, Nahal F. Selection of muscle and musculocutaneous flap in reconstructive surgery.
Ponten B. The fasciocutaneous flap: Its use in soft tissue defects of the lower leg. Br J Plast Surg. 1981;34:215-20.
Yadav A. Role of Local Muscle Flaps in Traumatised Lower Extremity. Thesis, Submitted for the Degree of M.S.(Ortho.), University, Delhi; 1988.
Ger R. The operative treatment of the advanced stasis ulcer. A preliminary communication. Am J Surg. 1966;111:659-63.
Ger R, Mccraw JB. Closure of defects of the lower extremity by muscle and myocutaneous flaps in Reconstructive Surgery of lower extremity. In: Converse JM, editor. Reconstructive Plastic Surgery: Principles and Procedures in Correction Reconstruction and Transplantation. Vol. 7., Ch. 86. Philadelphia, PA: W.B. Saunders Company; 1977.
Mathes SJ, McCraw JB, Vasconez L. Muscle transposition flaps for coverage of lower extremity defects: Anatomic considerations. Surg Clin North Am. 1974;54:1337-54.
Amarante J, Costa H, Reis J, Soares R. A new distally based fasciocutaneous flap of the leg. Br J Plast Surg. 1986;39:338-40.
Nahal HW, Stern PJ, Kreilein JG, Gregory RO, Webster KL. Complications of muscle-flaps transposition for traumatic defects of the leg. Plast Reconstr Surg. 1983;72:512-7.
Robbins TH. Use of fasci-muscle flaps to repair defects in the leg. Plast Reconstr Surg. 1976;57:460-2.
Barclay TL, Cardoso E, Sharpe DT, Crockett DJ. Repair of lower leg injuries with fasciocutaneous flaps. Br J Plast Surg. 1982;35:127-32.
Barford T, Pers M. Gastrocnemius-plasty for primary closure of compound injuries of knees. J Bone Joint Surg. 1970;52:124-7.
Donski PK. Distally based fasciocutaneous flap from the sural region. A preliminary report. Scand J Plast Res Surg. 1983;17:191-6.
James ET, Gruss JS. Closure of osteomyelitis and traumatic defects of the leg by muscle and musculocutaneous flaps. J Trauma. 1983;23:411-9.
Riegels-Nielsen P, Krag C, Medgyesi S, Pers M. The repair of soft tissue defects in the lower leg. A comparison of different flap techniques. Acta Orthop Scanda. 1983;54:772-6. 16. Tobbin GR. Hemisoleus and reversed hemisoleus flaps. Plast Reconstr Surg. 1985;76:87-96.
Kojima T, Kohno T, Ito T. Muscle flap with simultaneous mash skin graft for skin defects of the lower leg. J Trauma. 1979;19:724-9.
Woods JF, Irons GB Jr., Masson JK. Use of muscular, musculocutaneous and omental flaps to reconstruct difficult defects. Plast Reconstr Surg. 1977;59:191-9.
Vasconez LO, Bostwick J 3rd, McCraw J. Coverage of exposed bone by muscle transposition and skin grafting. Plast Reconstr Surg. 1974;53:526-30.
Published
How to Cite
Issue
Section
Copyright (c) 2023 VISHNU PAL
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.