Free Vascularized Flaps and Pedicle Flaps to Cover Traumatic Skin Defects of the Lower Extremity.

概要

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18 flaps including 9 free vascularized flaps and 9 pedicle flaps were used to cover traumatic skin defects of the lower extremity. All patients were male ranging in age from 3 to 64 years (mean 31 years). 9 vascularized flaps comprised latissimus dorsi flaps (4), lateral upper arm flaps (2), medial plantar flaps (2) and one groin flap. 9 pedicle flaps were made up of 2 medial plantar flaps, one gastrocnemius flap, one soleus flap and 5 other different flaps. 17 flaps survived completely. A reversed fasciosubcutaneous flap developed partial necrosis and required skin grafting. 2 free and 2 pedicle medial plantar flaps were used to cover the weight bearing area without developing a skin ulcer. Free flaps could cover any part of the lower extremity. Pedicle gastrocnemius flaps could cover the anterior aspect of the knee and proximal 1/2 of the tibia. Soleus flap could cover the middle 1/3 of the tibia. However, few pedicle flaps were able to cover large skin defects at the distal 1/3 of the tibia, where free flaps are indicated. Reversed flaps may not be reliable in traumatic skin defects with fracture because of the high incidence of vascular injury.
西日本整形・災害外科学会の論文