Pedicled thoracoumbilical flap coverage for wounds around elbow: A versatile option

Abstract

Background: To evaluate the reliability of pedicled thoracoumbilical flap for reconstruction of soft-tissue defects around the elbow. Materials and Methods: This was a prospective study undertaken between September 2017 and November 2018, in division of plastic and reconstructive surgery of our institution. Patients with soft-tissue defect of the elbow referred from the division of orthopedic surgery were included. Those with a scarring in the region of thoracoabdominal flap were excluded. A detailed history and examination were recorded. An informed consent was taken from every patient. Anteroposterior and lateral radiographs of the elbow were taken in all cases. Pedicled thoracoumbilical flaps were raised in all patients for the coverage of soft-tissue defects around elbow. Pedicle division and final inset were done after 4 weeks in all cases. All patients were followed up regularly. Results: A total of 5 patients with soft-tissue defect around the elbow were referred to our division from the division of orthopedic surgery. All patients were male with a mean age of 33 ± 6.67 years (25–40 years). The injuries were common in labor class, and the most common etiology being fall from height in three out of five cases. The right elbow was often injured (three out of five cases). In all patients, the wounds were of Gustilo Anderson grade IIIB. In one case, the implant was exposed (case 3). The mean defect size was 45.75 ± 6.29 cm2, and the mean flap size was 171.85 ± 13.12 cm2. No complications were seen in our case series. Conclusion: The pedicled thoraco-umbilical flap is technically simple and versatile option for the coverage of soft-tissue defect around elbow since it is vascularity is predictable.