Lower Leg Flaps Comparison Between Free Versus Local Flaps

Abstract

Background: In lower leg defects with bone, hardware, or articular joint exposure, a free tissue transfer is often the only valuable option. However, in well-selected clinical cases, local flaps are still indicated because they provide an alternative for the more demanding and risky microsurgical procedure. Methods: Twenty-six muscle flaps (performed in 26 patients) were reviewed retrospectively and compared with a series of 24 free flaps (23 patients) for lower leg reconstruction of almost similar indications. All patients with defects less than 25 cm2, peripheral vascular disease, deep defects, and osteomyelitis were excluded in order to obtain the same surgical indications .Also excluded were cases which needed split skin graft. Results: The overall surgical results were comparable, but more medical complications, a longer operative time, and a longer hospital stay were seen in the free muscle group. Conclusions: Free flap coverage is not mandatory to cover bone in the lower leg. The non-free flap can provide a good alternative for free flap coverage. This flap seems to have fewer medical complications, requires a shorter operative time and hospital stay, and can provide better aesthetic results than a free muscle flap depending upon selection of cases. Presented at the Sir Peter Feyer Memorial meeting of surgery, in Galway, Ireland, Sep1 to Sep 2, 2006,