Islanded gastrocnemius musculocutaneous flap for coverage of large wound in the leg and knee
INTRODUCTION: Gastrocnemius muscle flap can only cover small wound in the proximal tibia. The flap size can be increase by including the skin overlying the muscle. The area of coverage and the reach of the flap will increase The main problem with this flap (gastrocnemius musculocutaneous flap)...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association (MOA)
2018
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/63984/ http://irep.iium.edu.my/63984/ http://irep.iium.edu.my/63984/1/63984_Islanded%20Gastrocnemius%20Musculocutaneous.pdf |
| Summary: | INTRODUCTION:
Gastrocnemius muscle flap can only cover small
wound in the proximal tibia. The flap size can
be increase by including the skin overlying the
muscle. The area of coverage and the reach of
the flap will increase The main problem with
this flap (gastrocnemius musculocutaneous flap)
is the donor site morbidity because the expose
soleus muscle raphe doesn't take the skin graft
very well. To overcome this problem, we are
now islanded the skin paddle and by doing this,
the donor site can be closed primarily. Thus
covering the soleus muscle raphe and avoiding
skin graft over it. The aim of this study is to
investigate the outcome of using gastrocnemius
musculocutaneous flap to cover large soft tissue
defect in the leg.
MATERIALS & METHODS:
A consecutive series of 11 patients underwent
islanded gastrocnemius musculocutaneous flap
surgery in Orthopaedic Department, Hospital
Tengku Ampuan Afzan Kuantan Hospital from
2004 till 2017.were reviewed retrospectively.
There were 8 males and 3 females with the
mean age of 30.6 years old (range 13 to 60).
Seven cases were due to open fracture grade
IIIB of the tibia, 2 due to degloving injury
exposing the patella ligament and the patella, 1
due to open fracture of patella and 1 due to
necrotising fasciitis. The wound size ranges
from 12 cm2 to 120 cm2.
RESULTS:
All flaps survived. Three patients require skin
grafting at the donor site while the rest the
donor sites were able to close primarily. Three
developed infection which requires
debridement. One healed after vacuum dressing,
one after bone transport and one after split
thickness skin graft
DISCUSSIONS:
Chung et al developed a gastrocnemius
adipofascial flap to overcome donor site
problem. Calderon et al used a VY island
gastrocnemius myocutaneus flap to allow
primary closure of the donor site. We create a
spindle shape skin paddle that allows us to close
the donor site primarily. The empty space left
after the muscle is transpose further facilitate
the closure of the donor site.
CONCLUSION:
Gastrocnemius musculocutaneous flap is
effective for coverage of large soft tissue defect
from the knee till half of the leg.
REFERENCES:
1. Chung YJ, Kim G, Sohn BK. Ann Plast
Surg. 2002; 49 :91-5
2. Mcgraw JB, Fishman JH and Sharzer LA..
Plast Reconstr Surg. 1978;62: 15-23
3. Calderon WL et al ,. Plast Reconstr Surg.
2006;118: 301-2 |
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