Flaps In Reconstructing Leg Defects: Our Experience At Kenyatta National Hospital

Abstract

Wounds of the leg requiring reconstruction with flaps can be a challenge to even the experienced plastic and reconstructive surgeons. While the reconstructive ladder provides a clear roadmap on handling such defects, local factors including the experience of the surgeons and the resources at hand determines which flaps could be carried out successfully. In this presentation, we share our experience at Kenyatta national hospital, a tertiary hospital in Kenya. This is a retrospective study of patients operated on with the authors between August 2008 and august 2012 with leg wounds requiring flaps to close. A total of fifty six patients were operated on with such defects. Mid third tibia accounted for up to 44 percent of the defects. Perforator flaps was the commonest flap performed (31percent) followed by the soleus muscle flap. The overall flap success rate was 92 percent. In conclusion, majority of lower limb defects as shown in this study can be successfully reconstructed with the use of local and regional flaps. The cross leg flap, despite its disadvantage still has a role in the management of a significant proportion of such wounds in our set up. However more efforts should be put in place so as to utilize free flaps since they may result in better functional and less donor site morbidity.