Transplantation Treatment of Extensive Soft-Tissue Defects in Lower Extremities with a Combination of Cross-Bridge Flap and Combined Free-Tissue Flap Covered by Vacuum Sealing Drainage: One Case Report.

Xiaohua Pan,Guangyao Wang,Tun Hing Lui

doi:10.2174/1874325001711010704

Abstract

This article reported the ultilization of cross-bridge flap transplantation and combined free-tissue flap transplantation to treat a 54-year-old male with Gustilo type III-C injuries. Thorough debridement, external fixation and vacuum sealing drainage were performed in the fist-stage treatment. After the removal of negative pressure on VSD devices, the joined free-tissue flaps and the cross-bridge flap were performed to repair the extensive soft-tissue defects. One month later the pedicle of cross-bridge flap was divided and the external fixator connecting both the lower legs was removed. In 3-month follow-up, the extensive defects was completely covered by a nearly normal skin and radiograph showed tibia and talus healing.

Highlights

With the increase in traffic, severe injuries of lower extremities caused by traffic accident and daily accidents happen more frequently than before [1]
Due to the thin texture of soft tissues and low ductility of skin in lower extremities, these injuries usually lead to the extensive soft-tissue defects with severe open comminuted fractures, infection, and injuries of nerves and main vessels, which consist mostly of Gustilo type III-C injuries [2]
The strategy of two-stage repair is regarded as a more reliable treatment for soft-tissue defects of the lower leg [7].for patient with extensive soft-tissue defects coupled with severe comminuted fractures, it is a more reliable treatment to apply the strategy of multiple-stage repair, which is very necessary for those severe wounds without suitable vessel for anastomosis

Summary

INTRODUCTION

With the increase in traffic, severe injuries of lower extremities caused by traffic accident and daily accidents happen more frequently than before [1]. Due to the thin texture of soft tissues and low ductility of skin in lower extremities, these injuries usually lead to the extensive soft-tissue defects with severe open comminuted fractures, infection, and injuries of nerves and main vessels, which consist mostly of Gustilo type III-C injuries [2]. Cross-bridge pedicled flap, which can provide a temporary blood supply for the transferred tissue, has been usually used to treat the soft-tissue defects without the suitable vessel for anastomosis with ipsilateral free flap [4]. The Open Orthopaedics Journal, 2017, Volume 11 705 innovative method This method makes full use of the advantages and avoids the disadvantages of both kinds of flap transplantation; namely, free-tissue flap transplantation and cross-bridge flap transplantation

CASE REPORT

DISCUSSION

CONCLUSION