Loco - regional Flaps for Lower Limb Reconstruction - A Retrospective Study

Dr. Selvan Ranganathan; Dr. Surya Rao Rao Venkata Mahipathy

Volume : VIII, Issue : VII, July - 2019

Loco - regional Flaps for Lower Limb Reconstruction - A Retrospective Study

Dr. Selvan Ranganathan, Dr. Surya Rao Rao Venkata Mahipathy

Abstract :

Background: Reconstruction of lower limb defects are always a challenge to the plastic surgeon due to the limited supply of local non–traumatised tissues and the precarious vascular supply post–trauma. The goal of reconstruction is to maintain form and function. Materials & Methods: This was a retrospective study conducted in the Department of Plastic Surgery, Govt. Chengalpattu Medical College & Hospital, Chengalpattu from December 2008 to December 2010. Patients with soft tissue defects involving lower limb requiring flap cover were included in the study. Orthopedic intervention was done as required. All patients underwent loco–regional flap cover as required according to the site and nature of the defect. The outcomes were later analysed. Results: Total of 40 patients was included in the study. Most common cause was due to road traffic accidents (RTA) in 30 cases and post infective defects in 10 cases. Right leg was involved in 28 cases and left in 12 cases. Out of the 30 traumatic cases, fractures were present in 16 cases, exposed bone without fracture in 10 cases and no bony exposure in 4 cases. Most commonly performed procedure was fasciocutaneous flaps (60%) followed by muscle flaps (40%). Complications were seen in 4 patients in the post–operative period. Conclusions: Lower limb reconstruction is a challenge, but there are many options of loco–regional flaps available. In our study, various types of fasciocutaneous, septocutaneous and muscle flaps were used to cover the defects according to the nature of the wound. In this study, skin and superficial soft tissue defects were covered with fasciocutaneous flaps whereas for deep defects and with exposed bone with or without fracture, a muscle flap was used with good results. Loco–regional flaps have the advantage of being single–staged, faster to perform and technically easier.