We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Wound coverage considerations for defects of the lower third of the leg.
- Authors
Bajantri, Babu; Bharathi, R. Ravindra; Sabapathy, S. Raja
- Abstract
Anatomical features of the lower third of the leg like subcutaneous bone surrounded by tendons withno muscles, vessels in isolated compartments with little intercommunication between them makethe coverage of the wounds in the region a challenging problem. Free flaps continue to be the goldstandard for the coverage of lower third leg wounds because of their ability to cover large defects withhigh success rates and feasibility of using it in acute situations by choosing distant recipient vessels.Reverse fl ow flaps are more useful for the coverage of the ankle and foot defects than lower thirdleg defects. The perforators in the lower third leg on which these flaps are based are often damagedduring the injury. In medium-sized defects of less than 50 cm2 size, local transposition flaps, perforatorfl aps, or propeller flaps can be used. Preoperative identifi cation by the Doppler is essential beforeembarking on these flaps. Of the muscle flaps, the peroneus brevis fl ap can be used in selected caseswith small defects. In spite of all recent developments, cross-leg flaps continue to remain as a usefultechnique. In rare occasions when other flaps are not possible or when other options fail it can be alife boat. In the author's practice free flaps continue to be the fi rst choice for coverage of wounds inthe lower third leg with gracilis muscle fl ap for small and medium defects, latissimus dorsi muscle fl apfor large defects and anterolateral thigh fl ap when a skin fl ap is preferred.
- Subjects
FREE flaps; TRAUMA surgery; LEG injuries; DOPPLER effect; PERONEUS brevis
- Publication
Indian Journal of Plastic Surgery, 2012, Vol 45, Issue 2, p283
- ISSN
0970-0358
- Publication type
Article