The Efficacy of Free Latissimus Dorsi Flap in Patients with Lower Limb Distal Extensive Injuries.

Mohamed Abdullah Mohamed El-Nahas, Tarek Fouad Keshk, Sherif Mohamed El Kashty, Ahmed Abdelaziz Talaab
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Abstract

Objectives: to elucidate our experience in the use of latissmus dorsi free flap for the surgical reconstruction of distal lower limb complex injuries, regarding the surgical techniques and the patients' outcome. Background: from the variable types of free flaps, the free transfer Latissimus dorsi (LD) musculocutaneous flap is considered a workhorse in lower limb reconstruction. Methods: A total of 16 patients with complex lower limb defects and deformities required surgical reconstruction were enrolled in this study. They underwent free LD flap reconstruction and followed up for 6 months. Results: The total number of patient was 16 patients; they had a mean age of 24.63 ± 11.9, with males constituting 75% of patients SD ( 11.94 ) .Most patients had RTA as a mode of injury (87.5%). Four patients (25%) presented to the hospital and underwent debridement after 6 months or more from the injury. At the end of follow up period, all the 16 patients had their constructed limbs preserved with no failure cases. Overall, three cases (18.8%) required reoperation (P = 0.013). Conclusion: The present study elucidates that the free LD flap had an excellent outcome in reconstruction of the lower limb distal extensive injuries, with 100% salvage rate, and low complication and reoperation rate. Other larger studies are recommended.
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背阔肌游离皮瓣治疗下肢远端大面积损伤的疗效观察。
目的:探讨应用背阔肌游离皮瓣修复下肢远端复杂损伤的手术方法及疗效。背景:游离皮瓣种类繁多,游离转移背阔肌(LD)肌皮瓣被认为是下肢重建的主力神。方法:选取16例需要手术重建的复杂下肢缺损和畸形患者。术后行游离皮瓣重建,随访6个月。结果:患者总数为16例;平均年龄24.63±11.9岁,男性占SD患者的75% (11.94),RTA为主要损伤方式(87.5%)。4例患者(25%)在受伤6个月或更长时间后就诊并接受清创。随访结束时,16例患者义肢均完整保存,无手术失败病例。总体而言,3例(18.8%)需要再次手术(P = 0.013)。结论:游离LD瓣在下肢远端广泛损伤重建中具有良好的效果,修复率100%,并发症和再手术率低。建议进行其他更大规模的研究。
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