Distal Lower Leg Local Random Fasciocutaneous Flaps

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Abstract
Significant open wounds of the distal third of the lower leg that require some form of vascularized flap have historically been covered with distant cross-leg flaps or more appropriately with microsurgical tissue transfers. The rediscovery of the "random" fasciocutaneous flap as a reliable single-stage option for proximal lower leg defects has been extended distally to allow an expedient alternative in lieu of these more complicated procedures. Over the past 7 years, 17 selected patients had closure of distal leg and ankle wounds with 19 local antegrade-oriented fasciocutaneous flaps. All eventually healed without serious sequelae, although 5 (26 percent) had minor complications, except for one case that could only be salvaged with a free-tissue transfer in order to prevent limb amputation. For small- or moderate-sized, uncontaminated injuries, this approach warrants consideration under appropriate circumstances as a simpler option that may permit satisfactory healing and avoids the known risks of microsurgical tissue transfers.

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