Comparative Study between Hemisoleus flap and Fascio-Cutaneous flap in Middle Third Lower Limb Infected Traumatic Wound
DOI:
https://doi.org/10.51985/JBUMDC2024358Keywords:
Wound Infection, Surgical Flaps, Trauma, Lower Extremity, Surgical Wound Dehiscence, Treatment OutcomeAbstract
Objective: To compare the outcome of hemi-soleus and fascio-cutaneous in terms of flap viability, complications and stable coverage in infected traumatic wound on middle third lower limb
Methodology: The study has a period of six months from October 29, 2019, to April 29, 2020, under the approval of the Ethical Review Board (ERB) with reference number SZABMU/457, the study aimed to investigate the outcomes of a specific intervention. The participant pool consisted of 120 individuals who met the predefined inclusion criteria, and each participant provided informed consent along with demographic information. The subjects were then randomly assigned to one of two groups. Subsequent to the surgical procedures, both groups were closely monitored in the post-operative phase, with meticulous recording of relevant data. The outcomes of interest were measured, and all information was systematically collected using a pre-designed Performa
Study Design and Setting: Original article, Department of Plastic Surgery PIMS
Result: The mean age of the patients was 37.09 years,109(90.83%) were male patients. Motor vehicle accident cause of injury was noted in 57(47.50%) patients and 5-7 cm size of defect was noted in 64(53.33%) patients. Few complications are found higher in Hemisoleus Flap group and few found higher in Fascio cutaneous flap group.
Conclusion: Results showed superior efficacy of hemi-soleus flaps, especially in open tibia fractures, with fewer complications. This supports their preference in managing such wounds, ensuring stable coverage and potential cost savings
References
Pooja GD, Sangeeta L. Prevalence and aetiology of amputation
in Kolkata, India: A retrospective analysis. Hong Kong
Physiotherapy Journal. 2013;31(1):36-40. DOI: 10.1016/j.hkpj.
12.002
Zeiderman MR, Pu LL. Contemporary approach to soft-tissue
reconstruction of the lower extremity after trauma. Burns &
Trauma. 2021;9(3): 024-28. DOI: https://doi.org/ 10.1093
/burnst/tkab024
Palm VF, Hoogendoorn JM, Verhage SM. The role of fibula
fixation in combined distal-third tibia and fibula fractures: a
systematic literature review. Archives of Orthopaedic and
Trauma Surgery. 2024 Jan;144(1):219-28.
Atia A, Vernon R, Pyfer BJ, Shammas RL, Hollenbeck ST.
The essential local muscle flaps for lower extremity
reconstruction. Journal of Reconstructive Microsurgery. 2020
Apr 17;37(01):089-96. DOI: 10.1055/s-0040-1709480
Falola RA, Rodriguez-Unda NA, Lombana NF, Altman AM,
Saint-Cyr MH. Pudendal Artery Perforator Flap and Other
Reconstructive Options in Perineal-Pelvic Reconstruction.
Perineal Reconstruction: Principles and Practice. 2023 Apr
(4):129-152.
Murtaza ME, Sajjad YA, Aslam MA. Comparison of outcome
in coverage of open fractures of Tibia with pedicled
fasciocutaneous flaps and muscle flaps with overlying graft
in patients presenting to Plastic Surgery Department, Lahore
General Hospital, Lahore. PJMH S. 2019;13(1):153-6.
Coombs DM, Churchill J, Cartwright P, Chughtai M, Sultan
AA, Samuel LT, Moskal JT, Hendrickson MF, Mont MA.
Soft tissue reconstruction for deep defects over a complicated
total knee arthroplasty: a systematic review. The Journal of
Knee Surgery. 2020 Jul;33(07):732-44. DOI: 10.1055/s-0039-
Mavrouli M, Mavroulis S, Lekkas E, Tsakris A. The impact
of earthquakes on public health: A narrative review of infectious
diseases in the post-disaster period aiming to disaster risk
reduction. Microorganisms. 2023 Feb 7;11(2):419. DOI:
doi.org/10.3390/microorganisms11020419
Naeem Jagani DL, Nambiar S, D’souza JJ, Borana C, Shah
N. Functional outcome of primary flap coverage and bony
fixation of severe open fractures: A prospective observational
study.
Chan JK, Harry L, Williams G, Nanchahal J. Soft tissue
reconstruction of open fractures of the lower limb: muscle
versus fasciocutaneous flaps. Plastic and reconstructive surgery.
;130(2):284e. DOI: 10.1097/PRS. 0b013e3182589e63
Economides JM, DeFazio MV, Golshani K, Cinque M, Anghel
EL, Attinger CE, et al. Systematic review and comparative
meta-analysis of outcomes following pedicled muscle versus
fasciocutaneous flap coverage for complex periprosthetic
wounds in patients with total knee arthroplasty. Archives of
plastic surgery. 2017;44(2):124. DOI: 10.5999/aps. 2017.
2.124
Velotti N, Limite G, Vitiello A, Berardi G, Musella M. Flap
fixation in preventing seroma formation after mastectomy:
an updated meta-analysis. Updates in Surgery. 2021
Aug;73:1307-14.
Adam R, Watson S, Jarratt J, Noble J, Watson J. Outcome
after flap cover for exposed total knee arthroplasties. A report
of 25 cases. The Journal of bone and joint surgery British
volume. 1994;76(5):750-3.
Andres LA, Casey WJ, Clarke HD. Techniques in soft tissue
coverage around the knee. Techniques in Knee Surgery.
;8(2):119-.DOI: https://doi.org/10.1097/ BTK.
b013e3181a7eaec
Tiengo C, Macchi V, Vigato E, Porzionato A, Stecco C, Azzena
B, et al. Reversed gracilis pedicle flap for coverage of a total
knee prosthesis. JBJS. 2010;92(7):1640-6. DOI: 10.2106/
JBJS.I.00195
Jung JA, Kim YW, Cheon YW. Reverse gracilis muscle flap:
an alternative means of skin coverage for recurrent infection
after TKA. Knee Surgery, Sports Traumatology, Arthroscopy.
;21(12):2779-83. DOI: https://doi.org/10.1007/s00167-
-2210-4
Demirseren ME, Efendioglu K, Demiralp CO, Kilicarslan K,
Akkaya H. Clinical experience with a reverse-flow anterolateral
thigh 18. Tolhurst DE, Haeseker B, Zeeman RJ, Barclay T.
The development of the fasciocutaneous flap and its clinical
applications. Plastic and reconstructive surgery. 1983;71(5):
DOI: doi.org/10.1016/j.bjps.2011.06.047
Rovere G, Smakaj A, Calori S, Barbaliscia M, Ziranu A, Pataia
E, Maccauro G, De Mauro D, Liuzza F. Use of muscular flaps
for the treatment of knee prosthetic joint infection: A systematic
review. Orthopedic Reviews. 2022;14(2). DOI: https://doi.org
/10.52965%2F001c.33943
Satter T, Khan MN, Awwal R. Soleus muscle flap for the
coverage of pre-tibial defect of middle third of leg. Bangladesh
Journal of Plastic Surgery. 2013;4(1):10-5. DOI: https://
doi.org/10.3329/bdjps.v4i1.18685
Ribeiro LM, Meireles RP, Brito IM, Costa PM, Rebelo MA,
Barbosa RF, et al . Comparison of outcomes in immediate
implant-based breast reconstruction: acellular dermal matrix
versus inferior dermal flap. Archives of Plastic Surgery. 2022
Mar;49(02):158-65. DOI: 10.1055/s-0042-1744404
Surasak, Jitprapaikulsarn., Kriangkamol, Benjawongsathien.,
Chawanan, Patamamongkonchai., et al . Combined medial
gastrocnemius and hemisoleus flap: a reproducible alternative
for open tibial fractures complicated with large or double soft
tissue defects. European Journal of Orthopaedic Surgery and
Traumatology, (2021). DOI: 10.1007/S00590-020-02772-6
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Copyright (c) 2024 Zarish Daniel, Faizan Rahim, Fahad Soomro, Sumeet Kumar, Hiba Rashid, Abdul Khaliq Malik
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