Cadaveric study and clinical application of turnover fascial flap for lower-limb defects

Cadaveric study and clinical application of turnover fascial flap for lower-limb defects Moderately sized defects of various etiologies are encountered frequently in the lower limb. Several reconstructive modalities are available. Majority of them do not meet all the desirable criterion of recipient and donor site. In a search for an optimal procedure, the fascial flap emerged. We found the fascial flap to be suitable and advantageous for many defects. This paper describes the anatomical basis, planning, technique, and application of the fascial flap. To establish the technique, we divided the study in to two parts (a) cadaveric dissection and (b) clinical application. Dissection in 12 fresh cadaver limbs confirmed the location of the perforators of the posterior tibial and peroneal vessels. It also visualised the rich vascular network associated on either side of the deep fascia. The findings also suggested the safe dimension of a retrograde flap which is the key to success. Convinced and encouraged with the above findings, fascial flaps were successfully used for moderately sized defects at various non-weight-bearing areas of lower limb in 20 patients. Out of these, eight were random flaps and 12 were pre-Dopplered perforator flaps. Out of 20, 16 flaps healed uneventfully . In four cases one had complete necrosis while another had partial necrosis. Two cases had complete graft loss although the flap survived. These cases were followed up from 6 months to 2.5 years with an average of 1.5 years. Fascial flaps provide gratifying results in the majority of moderately sized lower-limb defects in non-weight-bearing areas. It meets most of the requirements of reconstruction in a single stage. Therefore, wherever feasible this simple method is justified. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Cadaveric study and clinical application of turnover fascial flap for lower-limb defects

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Publisher
Springer-Verlag
Copyright
Copyright © 2011 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-010-0540-3
Publisher site
See Article on Publisher Site

Abstract

Moderately sized defects of various etiologies are encountered frequently in the lower limb. Several reconstructive modalities are available. Majority of them do not meet all the desirable criterion of recipient and donor site. In a search for an optimal procedure, the fascial flap emerged. We found the fascial flap to be suitable and advantageous for many defects. This paper describes the anatomical basis, planning, technique, and application of the fascial flap. To establish the technique, we divided the study in to two parts (a) cadaveric dissection and (b) clinical application. Dissection in 12 fresh cadaver limbs confirmed the location of the perforators of the posterior tibial and peroneal vessels. It also visualised the rich vascular network associated on either side of the deep fascia. The findings also suggested the safe dimension of a retrograde flap which is the key to success. Convinced and encouraged with the above findings, fascial flaps were successfully used for moderately sized defects at various non-weight-bearing areas of lower limb in 20 patients. Out of these, eight were random flaps and 12 were pre-Dopplered perforator flaps. Out of 20, 16 flaps healed uneventfully . In four cases one had complete necrosis while another had partial necrosis. Two cases had complete graft loss although the flap survived. These cases were followed up from 6 months to 2.5 years with an average of 1.5 years. Fascial flaps provide gratifying results in the majority of moderately sized lower-limb defects in non-weight-bearing areas. It meets most of the requirements of reconstruction in a single stage. Therefore, wherever feasible this simple method is justified.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Oct 1, 2011

References

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