Reconstruction Of Lower Limb Wide Defects With Perforator Flaps: Alternative Solution To Reconstruction With Free Flap

Abstract

Objective: Repair of lower limb congenital or acquired tissue defesct in proper shape and function is the main topic of plastic surgery. In this article, we investigated different treatment methods of this anatomical region which is difficult to reconstruction and alternative solution methods to reconstruction with free flap, and also reviewed the treatment algorithm depending on the localization and size of the defect. Material and Methods: In this study; between 2011 and 2017, 27 patients who were surgically treated with a soft tissue defect in the lower extremity were evaluated according to treatment alternative for defect location and advantages of perforator flap to free flap. There were lower extremity soft tissue defect located in the proximal 1/3 cruris in 7 patients, in the middle 1/3 cruris in 12 patients and in the distal 1/3 cruris in 8 patients. Result: Early venous congestion was observed in 3 cases and wound infection was observed in 1 case. Venous congestion resolved spontaneously, wound infection healed with appropriate wound care. In 3 cases, partial flap loss was observed distal to the flap, and was treated with wound care without the need for a second operation. Conclusion: Perforator flaps are a reliable and effective method for repairing soft tissue defects of the lower limbs and it can be applied successfully in the early period after trauma. We think that it can be applied safely cause of the surgical technique is relatively easy and does not require microsurgery.