Comparative evaluation in the treatment of chronic post-traumatic osteomyelitis of the lower leg: free flaps compared with local flaps

2001 ◽  
Vol 24 (3) ◽  
pp. 123-126 ◽  
Author(s):  
Christian Windhofer ◽  
A. Schwabegger ◽  
M. Ninkovic
Keyword(s):  
Comparative Evaluation ◽  
Free Flaps ◽  
Lower Leg ◽  
Local Flaps ◽  
Post Traumatic

scholarly journals Possibility of management of lower leg war burns with free flaps

2003 ◽  
Vol 60 (6) ◽  
pp. 741-745 ◽  
Author(s):  
Ljubomir Panajotovic ◽  
Jefta Kozarski ◽  
Snezana Krtinic-Rapaic ◽  
Bojan Stanojevic
Keyword(s):  
Wound Closure ◽  
Free Flaps ◽  
Lower Leg ◽  
The Other ◽  
Wound Treatment ◽  
Necrotic Tissue ◽  
Local Flaps ◽  
Reconstructive Procedures ◽  
Military Medical Academy ◽  
Medical Academy

Free flaps are used in the surgical treatment of burns for wound closure where the burn is too deep, and in case, when after necrotic tissue excision, the bones, tendons, nerves, and blood vessels remain bare. Covering of the exposed structures is commonly performed in the primary delayed, or in the secondary wound treatment. The possibilities of covering the defects of the lower leg with local flaps are limited. Free flaps are used when all the possibilities of the other reconstructive procedures have been exhausted. The defect of the soft tissue of the lower leg was covered with free flaps in the injured soldiers with deep burns, treated at the Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade. In one patient the wound closing was performed immediately after excision of necrotic tissues, and in the other two in the secondary management. The application of free microvascular flaps enabled the closure of large post excision defects of the lower leg in one operation. Our experience in the treatment of these soldiers point to the possibility of coverage of the exposed deep structures with free flaps as early as possible.

scholarly journals Cross-Leg as Salvage Procedure after Free Flaps Transfer Failure: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
F. Contedini ◽  
L. Negosanti ◽  
E. Fabbri ◽  
V. Pinto ◽  
B. Tavaniello ◽  
...  
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Lower Leg ◽  
Salvage Procedure ◽  
Soft Tissue Defects ◽  
Vascular Thrombosis ◽  
Flap Failure ◽  
Tissue Defects

Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a reconstructive challenge due to the scarce availability of local tissues and recipient vessels. Even when a free tissue transfer can be performed the risk of failure remains considerable. When a free flap is contraindicated or after a free flap failure, the cross-leg flap is still nowadays a possible option. We report a case of a male with a severe posttraumatic wound of the lower leg with exposed tibia fracture firstly treated with two consecutive latissimus dorsi muscular free flaps, failed for vascular thrombosis; the coverage was then achieved with a cross-leg flap with acceptable results.

scholarly journals Reconstruction of Achilles region defects: a single-center experience

2021 ◽  
Author(s):  
Cengiz Eser ◽  
Ozgün İlke Karagöz Ceylan ◽  
Eyuphan Gencel ◽  
Ibrahim Tabakan ◽  
Ömer Kokaçya ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Graft Loss ◽  
Perforator Flap ◽  
Skin Grafting ◽  
Free Flaps ◽  
Distinct Advantage ◽  
Local Flaps ◽  
Single Center ◽  
Secondary Healing ◽  
Artery Perforator

Background: Reconstruction of Achilles tendon and the overlying tissue defects is a challenging undertaking. The spectrum of available repair methods range from secondary healing to use of free flaps. Method: In this study, we retrospectively evaluated 14 patients who underwent reconstruction of Achilles region defect between 2016 and 2019 at a single center. Results: Reconstructions were performed with secondary healing (n=2), negative pressure wound therapy and skin grafting (n=2), free flaps (n=6), and local and distant flaps (n=4). Satisfactory aesthetic and functional outcomes were achieved in all patients. One patient developed partial skin graft loss. Marginal necrosis occurred in one of the local flaps. Wound dehiscence and flap retraction occurred in one of the free (superficial circumflex iliac artery perforator) flaps. One patient undergoing reconstruction with ulnar artery perforator flap developed intraoperative atrial fibrillation; the operation was terminated and reconstruction completed with skin grafting. Conclusion: Orthoplastic reconstruction should be kept in mind for Achilles tendon defects. Use of special digital imaging techniques facilitates flap surgery and helps minimize the risk of flap complications. Conventional approaches are suitable for shallow small skin lesions. Local flaps are good options for deeper skin defects owing to superior aesthetic outcomes. Superthin free flaps offer a distinct advantage in skillful hands. Use of multi-content free chimeric flaps for reconstruction of complex defects facilitates better anatomical repair. Cross leg or flow-through flaps may be considered in patients with compromised distal circulation. Selection of the most reliable approach for Achilles reconstruction is a key imperative to achieve favorable outcomes.

Treatment of Complex War Wounds of the Lower Leg with Free Flaps and Ilizarov Method - Our Experience

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
N. Ostojic ◽  
J. Kozarski ◽  
M. Košuti ◽  
B. Djordjevic
Keyword(s):  
Free Flaps ◽  
Lower Leg ◽  
Ilizarov Method ◽  
War Wounds

scholarly journals Double free-flap for a bimalleolar defect of lower leg and ankle

2016 ◽  
Vol 49 (01) ◽  
pp. 95-98
Author(s):  
Naren Shetty ◽  
Narendra S. Mashalkar ◽  
Sunder Raj Ellur ◽  
Karishma Kagodu
Keyword(s):  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
The Other ◽  
Limb Ischaemia ◽  
Distal Limb ◽  
Limb Defects ◽  
Recipient Vessel

ABSTRACTDouble free-flaps are necessary when tissue cover cannot be sufficed with a single flap. The other factors to be considered when using two free flaps for resurfacing of distal limb defects are the availability of more than one recipient vessel, the risk of distal limb ischaemia and the donor site morbidity of double flap harvest. If these factors are adequately addressed, double free-flaps can be safely executed for resurfacing distal limb defects with minimal morbidity. We report the simultaneous harvest and transfer of the anterolateral and anteromedial thigh flaps inset and vascularised as double free-flaps to resurface a large bimalleolar defect in a 14-year-old boy with no additional morbidity as compared to that of a single free tissue transfer.

Reconstruction of the Lower Leg With Percutaneous Aponeurotomy and Lipofilling: A Case Report

2019 ◽  
Vol 18 (3) ◽  
pp. 336-338
Author(s):  
Yooseok Ha ◽  
Hee Sang Yang ◽  
Seung Han Song ◽  
Sang-Ha Oh
Keyword(s):  
Soft Tissue ◽  
Lower Leg ◽  
Tissue Loss ◽  
Local Flaps ◽  
Soft Tissue Defects ◽  
Established Method ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Soft Tissue Loss ◽  
Tissue Defects

Soft tissue loss in the lower leg presents a challenge for reconstructive surgeons. When a defect is large, free flap transfer provides a well-established method, but local flaps are more convenient for small to moderately sized soft tissue defects. When a defect is very small, even local flaps are too invasive, leave additional scar, and cause bulky flaps. We present our case aiming to underline the usefulness of percutaneous aponeurotomy and lipofilling in a small lower leg defect with several advantages.

scholarly journals Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
F. W. Nangole ◽  
S. O. Khainga
Keyword(s):  
Wide Local Excision ◽  
Operative Time ◽  
Free Flaps ◽  
Local Flaps ◽  
Donor Side ◽  
Scalp Flap ◽  
Fascial Flap ◽  
Scalp Defect ◽  
Exposed Bone ◽  
Scalp Wound

Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin’s ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome. In conclusion wide defects of the scalp can be fully covered with a combination of local flaps. The axial scalp flap and the pedicle temporalis fascial flap where applicable provide an easy and less demanding option in covering such wounds. These flaps are reliable with good blood supply and have got less donor side morbidity.

The use of free flaps in the treatment of severe lower leg trauma

1992 ◽  
Vol 15 (2) ◽  
pp. 63-68 ◽  
Author(s):  
W. Boeckx ◽  
P. H. Blondeel ◽  
D. Van Raemdonck ◽  
P. Broos ◽  
P. Rommens
Keyword(s):  
Free Flaps ◽  
Lower Leg ◽  
Lower Leg Trauma
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