Fasciocutaneous flaps for lower extremity salvage - abstract

ABSTRACT

Compound injuries to the lower limb with substantial soft tissue loss are traditionally resurfaced with distant jump flaps, cross-leg flaps or local random flaps. They have a high incidence of flap necrosis, limited flap size, and involve prolonged immobilization and multiple procedures. The use of muscle flaps has a better prognosis but are technically difficult they detach functioning muscle and require expensive equipment. Fasciocutaneous flaps offer a solution as they provide soft tissue padding, have a rich vascular supply, are simple to perform with an avascular plane of dissection, lead to less contour defect and do not require rigid plaster immobilisation postoperatively. Over the past 12 months, we have used fasciocutaneous flaps in seven cases with exposed tibiae due to compound fractures and in an eighth case with an exposed calcaneus. Two of the patients had local transposition flaps while five had cross-leg flap, probably due to rinking of the flap postoperatively; the flap was sufficient to allow for excision and advancement. The immobilisation and length of hospital stay were significantly reduced. The value of the fasciocutaneous flap as a simple, safe method of providing well-vascularised, soft tissue coverage of defects of the leg has been demonstrated (AU)