Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of General Surgery

Background Coverage of soft tissue defects over the lower third of the leg still a difficult challenge to reconstructive surgeons. Local propeller flaps based on perforator vessels are a good addition to reconstructive surgery of the limbs. These flaps allow efficient coverage of small to medium wounds without the need to sacrifice a major vessel. No need for microvascular anastomosis and allows to replace like with like, the donor site can be partially or in some cases totally closed by the short limb of the flap. The aim of this study was to evaluate the role of propeller flaps in reconstruction of lower third leg and foot defects, and to propose an algorithm for this reconstruction. Materials and Methods In the current study 30cases of various lower third leg and foot defects were covered by perforator based propeller flaps. Defects were due to Trauma in 21 cases, gunshot injuries in 2 cases, electric burn in 1 case, 4 case of a chronic non healing ulcer and 2 cases with post burn scars. Handheld doppler was used to determine the perforators site. Results 19 cases healed completely with smooth postoperative course. five cases showed total flap necrosis, 2 cases showed marginal necrosis of the flap, and 2 cases showed partial loss of the dermis and 2 cases showed transient venous congestion. In most cases, the aesthetic result was optimal and patients were fully satisfied

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