Various Modalities of the Resurfacing of the Lower Limb and Its Outcome.

Introduction With a better understanding of local fasciocutaneous flaps, local muscle flaps, split skin grafts, myocutaneous flaps, cross-leg flaps, and microvascular free tissue transfers, soft tissue management has improved during the past few years. The present study was conducted to study the various modalities of resurfacing lower extremity wound defect and their clinical outcome in patients with lower extremities trauma. Methodology An observational study was done in the Department of Plastic Surgery at Baba Raghav Das (BRD) Medical College, Gorakhpur (UP), and Maharshi Vashishtha Autonomous State (MVAS) Medical College, Basti (UP), with 30 patients admitted for lower limb resurfacing irrespective of the cause of wound defect from December 2020 to November 2021. Age, comorbidities, wound features, surgical techniques, postoperative outcomes, and complications were all recorded from the patients' case sheets. Results All 30 patients in our study underwent some or other form of soft tissue cover suturing or healing with secondary intention or skin graft or flap cover. The majority of the patients underwent debridement and skin graft (70.0%). Flaps were used in the exposed tibia/joint/flexor surface of the limb. The donor area in all the cases was skin grafted. Conclusion Trauma and burns are the most common causes of soft tissue defects in the lower extremity. The major goal of the patient's treatment is to achieve rapid functional results and lesser cosmetic restoration, while using the least-invasive treatment procedure possible. The use of free flap is decreasing, while the use of local flap is increasing. However, it should be kept in mind that some procedures used to preserve function may not have the best long-term effects, and, in some instances, amputation may be required.

Reconstruction of bilateral tendoachilles with fascia lata graft.

A 19 year old male presented with progressive enlargement of both tendoachilles for 2 years and difficulty in walking for 3 months. The neurological history and examination revealed progressive mental deterioration and ataxia. The blood investigation revealed hypercholesterolemia. We report this rare case of cerebrotendinous xanthomatosis with bilateral tendoachilles enlargement, which was treated by excision of bilateral tendoachilles and reconstruction with fascia lata. The American Orthopedic Foot and Ankle Society hindfoot score was 93/100 bilaterally and the subjective evaluation of the patient showed very good results.

An isolated bilateral pure macrostomia in a 2-year-old girl.

Congenital macrostomia is a lateral orofacial cleft between the maxillary and mandibular components of the first branchial arch. Bilateral macrostomia is a rare entity. To date, 17 cases have been reported in the literature, with more than 50% isolated. We present a case of bilateral transverse facial cleft (macrostomia) in a 2-year-old girl. It was not associated with any other anomaly. The cleft involved only the soft tissues of the face. Hence, it was a pure macrostomia. She was the third female child of the family, with 2 elder sisters normal. Nutritional deficiency during intrauterine life and/or advanced maternal age can be causative factors. Transverse facial cleft was closed by Z-plasty incision, with good functional and aesthetic result.