Abstract

COVERAGE OF LEG DEFECTS

Ajay Kumar Pathak* and Pragati Awasthi

ABSTRACT

Background: The bones of the lower third are vulnerable to injury. Due to the paucity of soft tissues around them, the fractures that occur are often open. Most muscles become tendons at that level and in the case of soft tissue loss, skin graft may not suface and flap cover becomes mandatory. Conventional teaching recommends gastrocnemius muscle and myocutaneous flaps and fasciocutaneous flaps for the upper third leg defects, soleus flaps for the middle third defects and free flaps for the lower third defects. Aim: Different surgical options in management of lower third leg defects. Material and Method: The study was conducted from JANUARY 2018 to December 2019, in the Department of Plastic & Reconstructive Surgery Institute of Post Graduate Medical Education and Research (IPGME&R) and SSKM Hospital, KOLKATA. Result: 70 patients admitted to the Department of Plastic & Reconstructive Surgery and referred patients from Department of General Surgery & Orthopaedic Surgery, IPGME&R and SSKM Hospital, KOLKATA. Association of FLAP LOSS with Pedicled flap was statistically significant (p=0.0259). We found that association of Donor Site Morbidity with Pedicled flap was not statistically significant (p=0.7679). Conclusion: We consider that perforator propeller flaps are ideal in reconstructing small-medium defects of the middle and distal third of the leg, being safe, easy to perform, providing similar tissue in texture and thickness of damaged tissues, with low donor-site morbidity

Keywords: Lower third leg, Skin graft, Flap loss, Pedicled flap.