USE OF A COMBINATION OF TWO IPSILATERAL FLAPS TO COVER POST TRAUMATIC LEG DEFECTS

Abstract

INTRODUCTION-With advancement in the microsurgical techniques the free tissue transfer has become the rst choice to manage large leg defects which cannot be covered with a local ap.The other option is the cross leg ap.Free aps need an expert team, expensive instruments and plenty of time. Cross leg aps lead to a difcult postoperative period for the patient. When the tissues surrounding the defect are healthy and a careful planning is done, a combination of two local aps which are otherwise used singly for smaller defects may obviate the need for a free or cross leg ap in certain cases.In this study we evaluated the patients who had undergone a combination of gastrocnemius muscle and fasciocutaneous aps for covering the large leg defects. AIMS AND OBJECTIVES-The aim is to study the role of a combination of two local aps to provide cover for the large leg defects. MATERIAL AND METHODS-A retrospective analysis of 30 patients operated from June 2016 to July 2021 for the leg defects rd involving the upper 2/3 of the leg was done.In these patients the upper half of the defects was covered with gastrocnemius muscle ap and the lower half was covered with inferiorly based fasciocutaneous ap. All patients had been followed till the wound cover became stable. RESULTS-All patients were males between the age group of 16 to 46 years. Leg defects were exposed tibia or implant and were post-traumatic in all the cases. Size of the defects ranged from 16cm to 18cm. In all the patients both aps survived well. Two patients had marginal necrosis of fasciocutaneous ap and one had discharge from underneath the muscle ap but were managed conservatively. CONCLUSION- A combination of gastrocnemius muscle and fasciocutaneous aps is a safeoption for covering large leg rd defects involving the upper 2/3 where surrounding skin and muscles are healthy