Title: Pretibial Defects of Legs: Coverage Management

Author: Dr Sumit Singhal MS, MCh (Plastic Surg)

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.102

Abstract

Paucity of protective subcutaneous fat layers, muscles, presence of only tendons, vessels in tight compartments with little collateral circulation make coverage of wounds in lower third of leg and down a challenging problem. Free flap operations are gold standard these days but need high microsurgical skills and operating Loupes or microscope.

Small to medium sized defects can be covered with perforator based flaps from the vicinity of the defect without much difficulty. Preoperative Doppler mapping of perforators is must. Secondary defects covered with split thickness skin grafts.

Keywords: Pre tibial defects, perforator based faciocutaneous flaps, Doppler study.

References

  1. Hallock GG. Local fasciocutaneous flaps for cutaneous cover of lower extremity wound. J Trauma 1989;29:1240
  2. Hallock GG. Distal lower leg local random fasciocutaneous flaps. Plast Reconstr Surg 1990;86:304
  3. Amarante J, Costa H, Reis J,Soares R; A new distally based fasciocutaneous flaps of the leg. Br J Plast Surg 1986;39:338
  4. Hasegawa M, Torii S, Katoch H, Esaki S. The distally based superficial sural artery flap. Plast Reconstr Surg 1994;93:1012
  5. Lees V, Townsend PL. Use of pedicle fascial flap based on septocutaneous perforators of the posterior tibial artery for repair of distal lower limb defects. Br J Plast Surg 1992;45:141
  6. Lin SD, Lai CS, Chou CK, Tsai CW, Tsai CC. The distally based posterior tibial arterial adipofascial flap. Br J Plast Surg 1994;47:132
  7. Niranjan NS, Price RD, Govilkar P. Fascial feeder and perforator based V-Y advancement flap in the reconstruction of lower limb defects. Br J Plast Surg 2000;53:679
  8. Wei F C, Mardini S. Flaps and Reconstructive surgery,2nd edi, Text book. Elsevier 2017; 717-750.

Corresponding Author

Dr Sumit Singhal MS, MCh (Plastic Surg)

Associate Professor, Deptt. of Surgery, Pacific Institute of Medical Sciences, Umarda, Udaipur 313001 Raj.