PROPELLER FLAPS IN DISTAL LOWER LIMB RECONSTRUCTION : OUR INSTITUTIONAL EXPERIENCE

Dr. Nirmal Kumar Gupta; Dr. Pradeep Gupta; Dr Arti Gupta; Dr. Mathura Prasad Agarwal

Volume : IX, Issue : VI, June - 2019

PROPELLER FLAPS IN DISTAL LOWER LIMB RECONSTRUCTION : OUR INSTITUTIONAL EXPERIENCE

Dr. Nirmal Kumar Gupta, Dr. Pradeep Gupta, Dr Arti Gupta, Dr. Mathura Prasad Agarwal

Abstract :

Reconstruction of soft tissue defect in the lower limb is challenging due to thin non – expandable soft tissue and lack of reliable local flap options. Traditionally in reconstruction of lower limb soft tissues defect, muscle flaps have been the gold standard for Gustillo Anderson grade IIIB. The defect in this area often requires microsurgical free flaps. With an increase understanding of the perforator flap concept, we applied the propeller flap to provide local flap coverage of different defect in lower limb. Material and Method: We present our experiences with 15 cases of propeller flaps performed between September 2013 to July 2016 in our institute. All defects were traumatic in nature and classified as Gustillo Anderson grade IIIB. Perforator were marked preoperatively with help of hand held doppler. Perforator was identified intra operatively and traced to major vessel. Skin paddle was designed around perforators. Skin paddle was than rotated in to defect. Result: Outcome of all the flaps was excellent except one case which underwent epidermolysis. There was distal congestion initially in four flaps but improved on day second and third post– operatively. No vascular re–exploration was performed. Conclusion : Propeller flap are reliable and versatile option for reconstruction of lower and middle leg soft tissue defect with associated grade IIIB fracture.