Tibial Cortex Transverse Transport: A Novel Treatment of Large Area of Deep Wounds in the Patient's Lower Extremities

Abstract

Category: Trauma; Other Introduction/Purpose: Large area of deep wounds (LADW) usually undergoes flap grafting, in this study, we propose an innovative treatment for LADW. The objective of our study was to evaluate the efficacy of TTT for the treatment of LADW in the lower extremities and provide indications for the TTT. Methods: A retrospective review of consecutive patients with Large Area of Deep Wounds in the lower extremities who underwent reconstruction using the TTT procedure from 2018.1 to 2021.6 was conducted. Inpatient follow-up was performed at 1 month after surgery and outpatient follow-up at 3, 6, and 12 months after surgery. Ulcer healing and healing time, recurrence rate, major amputation rate, and complications were assessed during this 1-year follow-up. All patients were evaluated by computed tomography angiography (CTA) 1 month after surgery for changes in the small blood vessels of the lower extremities. Results: A total of 36 patients, including 21 males and 15 females, with a mean age of 62.5 years, were in this study. These included infected skin defects (20 cases), traumatic skin defects (9 cases), tumor resection skin defects (6 cases), and burns (1 case). Among them, the healing rate was 94.4% and the average healing time was 6 months without recurrence, nail tract infection, osteomyelitis, incisional infection, and related complications. Conclusion: The results showed that TTT can safely and effectively treat total skin defects of the lower extremity. TTT is relatively simple to perform without grafting, making it an effective method for treating total skin defects of the lower extremity.